Ambulance Franchise Information

The Forsyth County Emergency Services (FCES) EMS Division relies on non-emergency ambulance franchise operators to augment the emergency response system already in place in the County. FCES will accept applications for new ambulance franchises that are postmarked from January 1, 2012 until February 28, 2012. Only applications postmarked during this time period will be accepted.

Interested parties may download the appropriate documents below:

Instructions for Completing Application:

1)      Use only black or blue ink.

2)      Complete all portions and fields of the application. If an applicant believes that a particular field does not apply to their business, indicate such by writing “Not Applicable” or “N/A” in said field.

3)      For Item #17, attach additional sheet(s) if necessary.

4)      For Items 20-36 and 38-45, place a check mark in the check-box to indicate that the attachment has been included in the application and to the right of “Label Assigned (i.e., Attachment 1):” write the name you have assigned to the corresponding attachment.

5)      All attachments must be in typewritten format, labeled and stapled individually.

6)       Upon completion:

      a)  Ensure that you have completed the Signature section of the application.

b)            b)  Place the original application, and three (3) complete copies, in an adequately sized mailing package (DO NOT FOLD).

           c)  Enclose a certified check, payable to Forsyth County, in the amount of $1,275.00.

           d)  Mail the application packet to:

Major R.L. Overman

Forsyth County Emergency Services

911 E. Fifth Street

Winston-Salem, NC 27101

Upon receipt, the individual listed in Item #18 as the “Application Contact” will receive a confirmation email verifying that the application has been received. Please DO NOT contact Forsyth County in reference to application review status.

Application will be evaluated and recommended for approval by the Board of Commissioners based on the County’s need for additional providers; the extent to which the proposed service enhances the County’s emergency response capability; and the financial and operational strength of the applicant.