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Operation of medical transport - applying for a permit

Do you wish to operate medical transport or alter or extend your existing approved medical transport company? Then you need to obtain a permit before starting the company or altering or extending your existing business.

Scope and content of the permit

The permit applies

  • to the applicant person as an entrepreneur
  • for medical transport in a defined area and
  • for the individual vehicle with an official numberplate.
  • Attention: You can obtain the permit for a maximum of four years. Should you wish to continue the business after the expiry of the permit, you need to apply for a new one in good time before the permit expires.

The permit includes the following ancillary provisions:

  • Operation and carriage obligation
  • Setting the hours of business
  • Ensuring proper hygiene practices
  • Compliance with the regulations of the ordinance concerning the operation of companies for the carriage of persons
  • Conclusion of an agreement concerning financing with the cost payers in the area of emergency services (statutory health insurance companies)
  • Brokerage monopoly of the integrated management locations / emergency services team

Note: The approval authority can issue additional ancillary provisions according to its own discretion. These can regulate

  • the working relationship of the companies amongst themselves and with the local committee for the emergency services and
  • place an obligation on the companies to document the carriage orders and their performance.

In addition, you must ensure that your plans for medical transport are included in the local plan for the area of emergency services.


  • Ensuring the stability and performance capability of the company. The financial status of the entrepreneur is decisive here. There must be an adequate economic basis for the provision of business equipment, vehicles and personnel.
  • Reliability of the applicants. There are strict rules for reliability due to the legally protected interests of human life and health associated with patient transport.
  • Professional suitability of the applicant. You must prove your professional suitability by means of an examination or reasonable employment at a company which is involved in the carriage of persons. In addition, the applicant must
    • have passed a paramedic examination or
    • provide proof of three years’ experience at an emergency service company or participation in the emergency services as an emergency paramedic, emergency assistant or emergency medical technician.

The ambulances used must have special equipment and must be identified as such in accordance with the registration document. You need to staff these vehicles with two suitable people, and at least one paramedic must look after the patients at all times.

Responsible department

  • if your place of business is in an urban district: the city administration
  • if your place of business is located in a rural district: the rural district office

Standard port

Enter the name of the municipality or town of your premises in the choice of towns.


The permit should be applied for by the entrepreneur or a person involved in the management of the company personally at the responsible city administration or rural district office. Depending on the services provided by the city administration or rural district office, the application forms are available for downloading. When making the application, it is recommended to submit the documents personally, so that any questions which arise can be responded to. The application must contain the following information:

  • Applicant person
  • Operating area
  • Operating and provision periods
  • Designation of the ambulance with the official licence plate number or a list of the ambulances with the official licence plate numbers

You must notify the responsible body once you start trading, stating the area of business, as well as provide information relating to the individual vehicles with official registration numbers.

Required documents

  • Passport or personal ID card of the person submitting the application
  • Ensuring the stability and performance capability of the company.
    • Proof of equity or statement of assets signed by a tax adviser, tax representative, auditor or bank.
    • Certification in tax matters by the tax office
    • Certification in tax matters by the tax local district
    • Certificate of good standing of the social security providers stating that the payments for health, pension and unemployment insurance of the employees have been paid correctly.
    • Certificate of good standing of the professional co-operative in relation to proof of payment of the accident insurance contributions.
    • If applicable, transcript of the entry in the commercial register or register of co-operatives at the local court (Amtsgericht).
    • If applicable, articles of association with a list of the shareholders.
  • Proof of suitability on the part of the applicant.
    • Current certificate of good conduct stating "0" (for submission to an authority)
    • If applicable extract from the central traffic register
    • If applicable extract from the central trade register
  • Proof of professional suitability on the part of the applicant. The necessary professional suitability can generally be provided on the part of emergency services providers named in Emergency Services Law. In case of another company, it is only necessary to determine suitability when the permit is being applied for for the first time.
    • Proof of three years of management experience at a company which is involved in the carriage of persons or
    • Proof of completion of an examination which meets the requirements of the professional access ordinance for the carriage of persons.
    • Proof of completion of the examination for the profession of emergency medical technician or
    • Proof of at least three years of active work in the emergency services as an emergency medical technician, emergency assistant or emergency paramedic.
  • Other proof:
    • Copies of the vehicle certificates, which state that the medical transport vehicles have been recognised as such and
    • Proof of the main inspection of the medical transport vehicles
    • Proof that the medical transport vehicle carries two suitable persons as required, whereby at least one emergency medical technician must look after the patients (for example rota, certification by the local committee).
    • Proof of satisfactory hygiene practices (for example by submitting a hygiene plan agreed with a hygienist).
    • If applicable, remuneration agreement with the cost payers. You can also submit these later.

Note: In special cases, the responsible body can request additional documents.

For example:

  • Points information from the central traffic register.
  • Translations


The fee must be paid for the permit. Check the level of charges with the competent body.

Note: In case of statutory service providers in the area of emergency services, the responsible body can reduce or cancel the fees.

Release note

The German original version of this text was drafted in close cooperation with the relevant departments. The Innenministerium released it on 01.07.2021. Only the German text is legally binding. The Federal State does not assume any liability for the translated texts.

In cases of doubt or if you have any questions or problems, please contact the relevant authorities directly.