Authorization to operate


County opt-in/opt-out

Starting July 1, 2024, Colorado counties/cities-and-counties will be required to issue or opt out of issuing local authorization to operate for ground ambulance services. Colorado counties must notify the department annually of their intent to issue local authorization to operate. Use this form after July 1, 2024, to inform the department of the intent to issue local authorization to operate.

Counties/cities-and-counties that choose to issue a local authorization to operate must notify the department within thirty days of issuing or terminating an ambulance service’s local authorization. If a county/city-and-county changes their decision related to issuing local authorization to operate, they must notify the department within thirty days.

After August 1, 2024, licensed ambulance services operating regularly in a jurisdiction that's chosen to issue local authorization but hasn't done so, will be considered to have obtained authorization until; the county/city-and-county implements an authorization to operate process or opts out of issuing authorization to operate.


Ground ambulance services - Steps to obtain local authorization

Starting July 1, 2024, licensed ground ambulance services are required to obtain local authorization to operate from the county or city-and-county in which the ambulance service operates or seeks to operate. Follow the steps below to obtain local authorization.

  1. Verify if the county or city-and-county has opted in to issue local authorization to operate.
  2. Determine if your ambulance service falls under the criteria of needing to request local authorization to operate in the county or city-and-county by reviewing 6 CCR 1015-3 Chapter Four Section 16.2.
  3. If needed, contact the county or city-and-county to apply for local authorization to operate.