EMSA Interested Parties Mailing List Form

Pursuant to Government Code Section §14911, the California Emergency Medical Services Authority (EMSA) is required to maintain a mailing list of interested parties and, on an annual basis, correct, verify and update the list of subscribers.

To receive notifications of EMSA's proposed regulations and rulemaking activities, please complete the fields below and submit this form.
 
A printable copy of this form is available and may be submitted by mail, fax or via email. If you would like a printable copy or have any questions, please contact regulations@emsa.ca.gov.

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* 1. FIRST NAME

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* 2. LAST NAME

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* 3. ORGANIZATION / COMPANY NAME

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* 4. EMAIL ADDRESS

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* 5. SECONDARY EMAIL ADDRESS (if applicable)

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* 6. MAILING ADDRESS (i.e. 123 Main Street)

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* 7. CITY

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* 8. ZIP CODE

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* 9. STATE

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* 10. ZIP CODE

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* 11. SUBSCRIBE / UNSUBSCRIBE

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* 12. NOTIFICATION PREFERENCE

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* 13. Type of regulatory information you would like to receive notification on:

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