EMS Medical Director Program Applications
Our new Insurance application is now available. Fill out the relevant sections and include it with the documents requested below.
EMS Medical Director Application (pdf)
EMS Medical Director Group Practice Application (pdf)
EMS Group Practice Physician Supplement (pdf)
Include a copy of your CV, a copy of the contracts for each service for which you wish coverage, and a certificate of insurance showing you have "Med Mal" for your primary occupation. (This policy will cover your EMS medical direction contracts only.)
Mail the completed packet with original signatures to:
c/o Thomas James, EMS Program Manager
8201 N Hayden Rd
Scottsdale, AZ 85258
*All documentation is kept entirely confidential, on file with the insurance carrier only, and not available for any else to view.