Type of application - State of Michigan 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by selecting the reason for submitting your application: New, Renewal, or Change of Information. If applicable, indicate the specific change.
3. Next, check the appropriate level of agency: First Responder, Basic, Limited Advanced, or Advanced.
4. Fill in your company name and geographic service area where you will respond to emergency calls.
5. Provide your contact information including street address, city, state, zip code, phone number, fax number, and email address.
6. Indicate the type of staff (Paid, Volunteer) and type of service provided (e.g., Ambulance Operation).
7. If applicable, list any different names under which your life support agency operates.
8. Ensure that the legally responsible person signs and dates the application to verify compliance with licensing requirements.
9. Finally, review all sections for accuracy before submitting your application along with any required fees to the specified address.

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