ARKANSAS DEPARTMENT OF HEALTH TRAUMA AWIN RADIO APPLICATION 2026

1. Click ‘Get Form’ to open the ARKANSAS DEPARTMENT OF HEALTH TRAUMA AWIN RADIO APPLICATION in the editor.
2. Begin by filling out Section A: Contact Information. Enter your EMS Agency name, mailing address, city, state, zip code, contact name, email, and phone number.
3. Proceed to Section B: AWIN Installation/Repair Provider. Input the AWIN provider name, contact name, and their phone number.
4. In Section C: Vehicle Information, specify whether it’s a ground ambulance or rotor wing air ambulance. For new installations, provide the VIN or tail number. If transferring a radio to another vehicle, include both the old and new vehicle VINs or tail numbers.
5. Move on to Section D: Radio Information. Indicate if you are using a mobile or portable radio and provide the model type. Specify if the radio is owned by ADH and its serial number. If replacing an existing AWIN radio, include its serial number as well.
6. Finally, add any additional information required and ensure all sections are completed before submitting your application.

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