33-36-02-03. Application for license.

An application for licensure as an emergency medical services training institution may be submitted on a form provided by the department or an alternate format which includes the following information:

1. Applicant information: a. Name of the training institution; b. Mailing address; c. Telephone number; d. Name of program coordinator; e. Name of training institution medical director; and f. E-mail address of contact person;

2. A copy of the written agreement with the physician medical director;

3. A copy of the written agreement with the hospitals, clinics, ambulance services, and physicians' offices that will provide field internship training;

4. A listing of the names of the persons or organizations that have financial interest in the institution;

5. A copy of the student handbook for the institution; and

6. A signed statement attesting to the accuracy of the application and all of its attachments.

History: Effective January 1, 2006.

General Authority: NDCC 23-27-04.3

Law Implemented: NDCC 23-27-04.3