Rule 4766-3-18 | Incorporated by reference.
(A) "Ambulette Inspection" form or form "EMS 4019" (February 2021) can be accessed at the division's website at http://www.ems.ohio.gov/medical-transportation-forms.aspx.
(B) The MTLS online system collects and manages information in categories including service details; medical director; call volumes; communication equipment; service areas; contact information; insurance details; vehicle liability; company executives; satellite locations; vehicle information; and facility and vehicle inspection information. MTOs register and create an account to access the MTLS online system and use it to apply for, renew, and manage a medical transportation license.
(C) "Periodic Mechanical Safety Report" form or form "EMS 4039" (July 2021) can be accessed via the division's website at http://www.ems.ohio.gov/medical-transportation-forms.aspx.
(D) "Violation Notification" form or form "EMS 4029" (July 2021) is issued by the board to an ambulette service/non-emergency medical services organization that is in violation of Chapter 4766. of the Revised Code and agency 4766 of the Administrative Code and a sample of the form can be viewed at http://www.ems.ohio.gov/medical-transportation-forms.aspx.
Last updated June 15, 2022 at 9:52 AM
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