Instructions:

1. Download the PDF below.
2. Please have the PDF copy reviewed and signed by your Medical Control Physician.
3. Log back in to the Letters of Compliance User Options page and select edit.
4. On the last page of the form, check the box "Signed by Medical Control Physician" and a file upload box will appear.
5. Upload the signature page and select update.

* Required Field

Please let the staff at the OCMCA know of any changes throughout the year.

NOTE:  If any of the above criteria cannot be met, the provider will submit documentation explaining reasons for the exceptions.

This agency agrees to comply with the protocols, operating procedures and standards of pre-hospital care promulgated by MDHHS and the Oakland County Medical Control Authority.  This will assure accountability for care rendered within our advanced emergency care system, effective this date, and as may be promulgated from time to time.

We acknowledge that each criterion and verification are subject to inspection by the EMS Medical Director or his/her physician designee at any time and at his/her direction.  Should cause exist, the EMS Medical Director, or his/her designee may request formal verification.

Be advised that if your aircraft is not available 24/7 for emergency scene responses, your aircraft dispatch number will not be added to the OCMCA dispatch list that is provided to all OCMCA Life Support Agencies and Dispatch Centers.

COMPLIANCE:  If any of the above criteria cannot be met, the provider will submit documentation of the exceptions.

This agency agrees to comply with protocols, operating procedures and standards of pre-hospital care promulgated by MDHHS and the Oakland County Medical Control Authority, including the Agency and EMS Personnel Criteria for Participation Policy.  This will assure accountability for care rendered within our advanced emergency care system, effective this date, and as may be promulgated from time to time.

We acknowledge that each criterion and verification is subject to inspection by the EMS Medical Director or his/her physician designee, at any time, and at his/her direction.  Should cause exist, the EMS Medical Director, or his/her designee may request formal verification.