Please use this form when replacing or re-chassis of an ambulance in your fleet. If you are adding an additional ambulance to your fleet please use the Additional Ambulance Application in the e-licensing system.
The Ambulance Replacement Form should be e-mailed or faxed to the EMSRB EMS Specialist assigned to your ambulance service.
Replacement Vehicles and New Vehicles applications should be completed in the eLicense system. Upon completion, you will receive a notification authorizing use of the vehicle until an inspection can be completed.
ALS Hardship Variance Application - To be completed by Advanced Life Support (ALS) ambulance services applying for or renewing a Ambulance Staffing Hardship Variance in accordance with Minnesota Statutes, section 144E.101, Subdivision 7 (f).