Paid ambulance in Moscow and the region. Call within Moscow - 3450 rubles.

Commercial ambulance in Moscow - always in touch

Paid ambulance SkyMed LLC is an independent specialized service that provides pre-medical and medical care in Moscow and the region. We are always in touch; you can call a team any day and time of day.

Despite the fact that calling a private ambulance is paid, if on the way to the client someone needs medical assistance, the doctors will provide it immediately and free of charge. In addition to standard services, you can order from the company:

• ambulance duty at holidays and competitions;
• transportation of patients.

The paid ambulance service includes 20 teams, including intensive care units specializing in neurological, traumatic and childhood diseases. The carriages are equipped with modern equipment to provide emergency medical care and resuscitation. The transport used by private ambulance doctors to make paid calls regularly passes Maintenance, which eliminates the possibility of breakdowns along the way.

High-quality paid ambulance services in Moscow and the Moscow region

For all doctors of SkyMed LLC

Private ambulance: legal aspects, license, equipment, personnel, “kitchen”.

 

Private ambulance - a structure for round-the-clock emergency medical care for emergencies en route to medical institution or directly at the scene of the disaster.

This service is a popular way to enter the medical business. Everything is explained simply - the well-functioning system left as a legacy after the USSR is falling into decay, and the emerging middle class and the elite cannot meet their needs in the public sector. Private ambulance began to develop from the moment the whole private practice, approximately from 95-98 of the last century, but everything was formalized legislatively only in 2007, with the adoption of the law on licensing medical services in the final reading.

Key difference no from the state SMP, but due to the presence of an excellent material and technical base, high motivation employees and less workload on the average crew during the day, the patient can count on more individual approach, and in case of emergency, gets access to modern resuscitation equipment, which is not always possible in government structure. In addition, if the patient has the means, the ambulance can perform the functions of a local or family doctor, as well as provide consulting services - in essence, the client receives a large package on one hotline.

Legal points

Depending on the various situations the stage of formal creation of an ambulance can last up to six months. Most often, these are bureaucratic issues, for example, the license is signed personally by the head of Roszdravnadzor, and it requires decisions from Rospotrebnadzor, a sanitary and epidemiological conclusion on the strict compliance of work and services, tests, physical factors, water quality, washes for sterility - all this can take quite a long time.

The only option under necessary tasks LLC is a legal entity, a limited liability company. An LLC can recruit employees only after obtaining a license.

Optimal taxation - simplified tax system income minus expenses, 15%. OKVED - Health and social service provision, activities in the field of health care, paragraph 85.14.4, activities of emergency facilities medical care.

The method of payment with patients is only receipts; cash register is impossible in an ambulance carriage; receipts must be registered in a special journal for strict reporting forms.

How to get a private ambulance license

Licensing takes place in accordance with the requirements of Resolution No. 30 “On approval of the Regulations on licensing of medical activities” dated January 22, 2007. Deals with permitting papers Roszdravnadzor, licensing is unlimited. It is necessary to collect a package of documents and pay the price for services and fees, in case positive decision.

• A copy of the LLC charter and registration certificate.
• A copy of the conclusion from Rospotrebnadzor.
• Lease agreement or property documents.
• Lists of medical equipment and certificates of conformity.
• Papers for each employee, excluding the driver and accountant - diploma, post-graduate training, internship or residency, certificate and category rating.
• Application for consideration of the case and a check for the services of consideration and work on your issue.

Room for machine base

SanPiN requirements for the size of the premises and a mandatory bathroom must be met already at the stage of renting the premises. SanPiN 2.1.3.1375-03 “Hygienic requirements for the placement, design, equipment and operation of hospitals, maternity hospitals and other medical hospitals”

We need a base that will combine functions logistics center, garage and rest room, later you can expand the range of services, introduce several inpatient wards and a manipulation room, although it is optimal to do this at the opening stage in order to form a favorable opinion about the brand. There will also be a help desk, which also needs to be allocated a separate office - it will work with clients and guide crews; these employees also need a place to rest.

Equipment

It is quite possible to start even with one special car, especially considering the prices, approximately 900,000 rubles for a Gazelle chassis and 2 million for a Mercedes chassis. You can transport patients and go out on single calls, gaining experience client base. But Desired minimum: three cars- two linear and pediatric, one specialized cardio and resuscitation.

Of the equipment they usually put on each resuscitation kit (oxygen, manual ventilator, perfuser, defibrillator and cardiac monitor- its cost may vary, depending on the manufacturer, but preferably German and Italian manufacturers, if the budget allows). This is necessary for logistics purposes; sometimes a specialized team may be on call, and resuscitation measures should be carried out by the usual line personnel.

Technology and PBX with several channels, walkie-talkies for cars and the costs of their registration - also need to be taken into account. The upfront costs for medication refrigerators, List A safes, and the medications themselves can be quite significant. Acquainted with necessary equipment and consumables can be found in the “List of equipment for the visiting team” ( Appendix 1.13 of the order of the Ministry of Health Russian Federation dated March 26, 1999 N 100).

Staff

• Drivers, who must have excellent knowledge of the city - best of all, with experience in a state ambulance or taxi.
• Accountant- he can be hired before licensing, there will be enough work, especially in terms of reporting.
• Chief physician - administrator, director and person who controls all operational issues, with experience in management work.
• Crews- usually a doctor and a paramedic, preference for men who can carry a patient and get him out of a car. Usually there must be an obstetrician, a surgeon and a cardiologist; a narcologist is also often included in the team; calls to relieve withdrawal symptoms are not uncommon. Crews are staffed on a daily basis - three for each ambulance.
• Dispatching service- usually younger medical staff who can adequately assess the situation and make a decision about the need for a particular team to leave and, in general, about the advisability of calling.
• Sales Manager- a person who works with private insurance companies, with a corporate client, negotiates with city authorities to conduct city holidays and sporting events, offers services to individuals for monitoring and managing patients.

To start work, you usually need a fairly large team - from 20 people, in the case of 3 cars, in addition, you will need a nurse and a mechanic who can fix any problem in the car in emergency mode.

Private ambulance services

Typically, following the letter of the law, a private ambulance provides the following services.

• Maintaining remote advisory assistance and monitoring of seriously ill patients.
• Providing emergency medical care when indicated.
• Transportation of bedridden patients and people who, according to indications, require constant medical supervision.
• Detoxification activities at home - withdrawal from binge drinking and various abstinence.
• Call any specialist to your home for guidance or consultation.
• Servicing corporate events and celebrations.
• Additional medical services at the station - massage, exercise therapy, various courses.
• Segment health insurance- a promising and broad topic that goes beyond the scope of this review.

The target audience services - wealthy people who are dissatisfied with the quality of public ambulance services, people who need supervision and monitoring (bedridden and chronically ill patients). These are also young people with drug or alcohol addiction who does not want publicity or feels the need for medical supervision, a corporate client who needs to ensure mass events adequate medical care, middle class using health insurance.

How does the structure of private ambulance work?

To call a private ambulance, you need to make a call to the dispatcher - anyone who wants to can call it, not only a client of a private clinic and someone using an insurance policy. After receiving an incoming call on a landline phone, with a conversation recording function, the dispatcher carries out initial work with the patient - interviews him about symptoms, writes down the address, enters it in a strict reporting journal and in a special computer program. Payment is made after medical care is provided, since the “check” can “float” depending on the drugs used. It is worth paying attention to the fact that the standard package usually includes diagnostics, including a cardiogram.

After assistance, the patient is sent to the hospital according to indications. Typically, urgent patients and people who are unconscious end up in emergency hospitals and specialized departments, while chronic patients have a choice between private medicine and state aid. If the client uses insurance medicine, the certificate usually indicates the desired place of hospitalization, even if the patient is unconscious, you can easily navigate.

Reception department points to route sheet The crew arrives at the time of arrival, makes a preliminary diagnosis and signs that the patient has been admitted to the hospital. This is where all relationships between a private ambulance and a hospital institution end, the hospital is not responsible either to the private owner or to third parties, just as private owners are not responsible after they have admitted a patient.

Private entrepreneurship in Russia is developing and conquering new sectors of the service market every year. It is no longer new to use a private bank, security agency or ambulance. Open yours ambulance difficult, since this type of activity requires licensing and large investments. But if you are not afraid of difficulties and you have a certain amount in your stash, then you can try. Let’s talk in more detail about the specifics of the business of providing medical services and organizing private ambulances.

Business specifics

State bodies have transferred into private hands those areas that were previously inaccessible to entrepreneurs. These include housing and communal services, ambulance, education, and medical services. Of course, complaints about high cost There are many services that people are used to receiving for free, but positive reviews prevail.

For example, by calling an ambulance by phone 03, you can wait for doctors no earlier than 20-30 minutes later. A private ambulance will rush to the place in the shortest possible time - 5-10 minutes. It’s the same distance to travel to a patient in a state ambulance, but the staff is not always motivated, and they have a lot more challenges. IN private company specialists receive a salary and a percentage for each call and service provided, so a good goal and prosaic nature are intertwined. The doctor will rush to the patient and provide all the services he needs.

In addition, the Ministry of Health is receiving less and less funding, and high-quality modern equipment can only be found in private clinics. And a third of the success of treatment depends on its quality. Patients prefer to pay and receive help high level than using the policy and wasting time in queues.

According to statistics, 70% of entrepreneurs who are engaged in medical business in Russia do not have a medical education at all. Therefore, everyone will be able to open their own medical care service to the population.

Private ambulance services are provided to the public the following types services (the list in each private company can be expanded or narrowed):

1. Examination and consultation of the patient, diagnosis of the disease – 500–800 rubles.
2. Transporting a patient to a hospital or for diagnostics – 600-1000 rubles.
3. Providing first aid on site for a diagnosed disease – 500-1500 rubles.
4. Patronage and observation of a patient who needs constant monitoring - 2500 rubles/day.
5. Detoxification of patients (measures necessary to withdraw from drugs or alcohol intoxication) – 2500-4000 rub.
6. Accompaniment by medical staff of mass events or trips of schoolchildren - 3500-6000 rubles.
7. Additional services at the central ambulance office (ultrasound, ECG), consultation narrow specialists, massage – from 1200 rub.

Target audience - any person with average and high income. People who want to get help incognito (for example, drug addicts or alcohol addicts) also often turn to a private emergency room.

A private ambulance can receive additional income, concluding agreements with the same entrepreneurs who provide medical services. But the patient is given a choice of which hospital to be taken to – private or public.

The technical side of the business

For organization medical business must have a license. But it is difficult to obtain a document from Roszdravnadzor. You will have to undergo a series of checks from various government agencies, as a result of which you will be given written reports. Only an LLC can obtain a license to provide emergency medical services. Therefore, a limited liability company is initially registered. When registering, select a type code OKVED activities– 85.14.4 “Activities of emergency medical care institutions.”

A package of documents is submitted to Roszdravnadzor:

1. Statutory documentation of the company.
2. Application for a license. The form can be viewed on the Roszdravnadzor website.
3. Certificate.
4. Copy of passports and TIN of all founders.
5. Certificate of ownership or lease agreement for the premises where the emergency center is located.
6. Certificates of conformity for tools and equipment.
7. A copy of the conclusion from Rospotrebnadzor.
8. Copies of documents that confirm the education and qualifications of each employee of the company.

A detailed list of documents and requirements for medical equipment can be found in the SanPiN documents “On approval of the Licensing Regulations medical activities" You can download the list.

Red tape with documents can drag on for six months. It will take more than one week until the field commissions check you and each makes its own conclusion. Then a council meets, where a decision on issuing a license will be made.

Ambulance equipment

The most minimal equipment of a private ambulance will cost you at least 5 million rubles. Of course, you can start working with one car and a mobile team of several people, but such an “ambulance” may not be able to respond to all calls. Plus, if the team is busy doing field work, there will simply be no one to send to your clients.

The best option is to start working with four machines:

• Reanimation vehicle.
• Pediatric team car.
• Two line lines, for traveling to regular calls.

Each vehicle contains the following standard equipment:

• Defibrillator – 78-100 thousand rubles.
• Cardiac monitor – 150-300 thousand rubles.
• A device for artificial ventilation of the lungs – 60-100 thousand rubles.
• Perfusor (electronic syringe pump), 2-3 pcs for each machine, – 100-150 rub./pc.
• Oxygen apparatus – 30-150 thousand rubles.
• Mini-refrigerator for medicines – 20-40 thousand rubles.

A stationary refrigerator for storing medicines is installed in the company's office - 60-100 thousand rubles, a safe for storing drugs containing drugs - 50-100 thousand rubles. Each car is equipped with a walkie-talkie, a station is placed in the office - 90 thousand rubles. The most high costs when equipping the center, they will spend on a resuscitation vehicle; its price on the market in Moscow depends on the brand.

A car based on a foreign car like Mercedes-Benz Sprinter will cost 2 million 850 thousand. A car based on a GAZelle will cost a little less - from 1 million 500 thousand. We do not recommend buying used equipment, since the quality of equipment in your ambulance will The reputation of the company and the lives of patients will depend.

Selecting staff

For travel, staff are hired with medical education and work experience of at least 5 years. Newbies can screw things up, and one misdiagnosis can jeopardize the reputation of a startup company.

The doctors’ work schedule does not differ from the state one – every day or three. You can hire part-time specialists from large public clinics. But a license is issued subject to permanent employees, so you must have 3 doctors on a permanent basis: the head physician, the deputy and the paramedic.

In addition to medical personnel, drivers with knowledge of the city and suburbs are required. How quickly the on-call team will arrive depends on their experience. For major project an accountant is hired who will manage the financial part of the business, and dispatchers who take calls. Students of medical universities are suitable for the role of the latter. Young professionals are theoretically familiar with the symptoms of diseases and will be able to select the right field team.

Eventually

When opening your own emergency room, you should understand that you will have to invest a lot in the business. The company will pay for itself no sooner than in 2-3 years. It is difficult to recruit regular clients, since trust in doctors comes with time. When investing 5-10 million rubles into a business, do not forget that ambulances should first of all serve people. Therefore, any savings can cost you the collapsed reputation of the company, and for someone - their life.

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The private provision of paid medical services is gradually replacing state medicine. There are many reasons for this, the most important is low quality and the inefficiency of municipal institutions, whose employees, due to low salaries, are infantile and indifferent in the performance of their duties job responsibilities. This also includes the general neglect and poor funding of the medical sector from the state, which forces personnel to work on old and worn-out equipment, using cheap and low-quality drugs.

This did not escape the ambulance service, which is now represented by slowly falling apart GAZelles, in which doctors and paramedics are forced to work for minimal pay - needless to say, they have no motivation. Private medicine is thriving in municipal institutions Pensioners and poor people apply out of habit, while the middle class is actively starting to use the services of private individuals. like this integral part Entrepreneurs independent of the state are also beginning to open healthcare systems like emergency services.

The biggest challenge in such an undertaking is not the fight against competitors. No, of course they exist, especially in major cities, where such a practice will not surprise anyone, but after first studying the situation on the market, you can decide whether it is worth engaging in such a business; As a rule, private ambulance services are represented by only a few companies, whose capacities are the whole city may not be enough; in smaller cities and provinces such services are often not available at all.

Still, the most difficult thing is the clash with bureaucrats, from whom you will have to obtain permission for such activities. One cannot think that an ambulance requires fewer documents during registration, and registration is not so labor-intensive. The requirements here are the same as for opening a private clinic.

The first step is to hire staff. It is optimal to have five teams that will be on duty around the clock in anticipation of calls, which is why calculations are made for five ambulances. The schedule should be in shifts, work is expected every other day, that is, you need to hire 15 fully staffed crews. Each of them has 3 people: a driver, a doctor and a paramedic.

Next you need to hire dispatchers - 3-4 people depending on the work schedule, and just hire former employees Taxi services or even just people from the street are under no circumstances allowed; The dispatcher must be at least an experienced nurse or nurse in order to quickly assess the situation on the other end of the line and properly staff the crew, understanding whether a person called with a real illness or whether the caller has problems with suspiciousness or hypochondria, as well as filter out hooligan calls.

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Accounting can be transferred to third-party companies - it will be much cheaper, and maintaining accounting The medical industry requires highly qualified specialists. In a stationary room, in addition to dispatchers, a mechanic and a nurse will have to be on duty, and the head physician - a person with a higher medical education who has worked in a similar field for at least five years - will be required to manage the entire organization. The same applies to ambulance doctors.

When contracts have been concluded with all employee doctors, you can contact Federal service on supervision in the field of health care. After paying the fee for considering the possibility of obtaining a license (6 thousand rubles), you will have to provide a full package of documents, namely:

Copies employment contracts with employees who will provide medical services and occupy management positions, copies of their work books or other documents confirming the employee’s five-year work experience, copies of higher education diplomas educational institution in medical specialty.

Copies of all contracts for the sale or lease of premises and equipment, including ambulances, or other documents confirming the right to use them. In addition, premises must have permits from the fire and sanitary-epidemiological services. Like documents from previous paragraph, these must be notarized.

Copies of the subject's registration certificate entrepreneurial activity; optimal registration of a limited liability company indicating the code (OKPD 2) 86.10 Services of hospital organizations.

The waiting period for a decision on granting a license can be up to forty-five days, which can negatively impact personnel who long time waits together with the entrepreneur for a decision, already being officially employed, but not having the right to work. There are no official ways to hurry people from the ministry...

We must not forget about registering cars with the traffic police, where they must not only be registered, but also given permission to use flashing lights, which will give priority in traffic relative to other drivers. They will also require copies of registration certificates legal entity, the copy itself medical license and check the compliance of the beacon and sound signal with established standards. If the decision in both instances turns out to be positive, you can start working.

To do this, a small room must be available where teams are on duty. There is no need to seriously equip the premises; a hospital is not expected in such a business; a small warehouse for equipment and medicines and a waiting room will be enough. But the surrounding area should be sufficient for parking and servicing five cars.

Renting such buildings will cost at least 150 thousand rubles per month, and this should also include utility bills (5-10 thousand depending on the size of the parking lot and premises, and whether the call reception and waiting point is based in an area secured by private enterprises) . In addition to the above, a bathroom must be organized on the territory of the enterprise, including in the garage, cars must be constantly kept clean, including outside. In addition, every twelve hours they must be inspected by an experienced and hired mechanic for breakdowns and malfunctions; the car must be guaranteed to reach the client and, if necessary, take him to the place of further treatment. If any deviations are detected, the car mechanic must quickly eliminate the problem that prevents the car from entering the line; If it is impossible to do this on site, the transport must as soon as possible be sent for repairs. It is best to equip a full-fledged workshop; this will save you from unnecessary hassle and lost profits, not to mention the failure to provide assistance to those in need.

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The crews themselves are divided according to the functions they perform; three vehicles must be linear, that is, provide standard emergency medical care; another one is allocated for the resuscitation and intensive care team. But in the case of the employment of specialized teams, the linear ones must be quickly re-equipped in order to provide the necessary services. The team, and therefore the entrepreneur, is responsible for the person at the time of his transportation, as well as for the treatment provided, but if the patient is transferred to the clinic, then all responsibility is removed from the team at the time the emergency doctor signs the client’s placement in an inpatient medical facility.

You should be very careful when equipping your cars. A beginning entrepreneur has a choice: to purchase products from the Russian automotive industry or foreign ones. "GAZelles", "Sables" and similar products Russian genius automotive products have a cost of 500 thousand rubles, while some companies offer to buy a car already painted and equipped with flashing lights. The quality of such cars is well known, but they are easy to repair, it is not difficult to find technicians to service this equipment, and spare parts are inexpensive.

However, potential clients will perceive an ambulance in a UAZ in the same way as public service, that is, negatively, and there will be less trust in such doctors, which means they will call less often. Therefore, there is an alternative - chic-looking foreign-made cars, silent when driving, comfortable and respectable; but their cost starts from one million rubles for the most simple models(Peugeot Boxer, for example). What exactly the crews will drive is decided by the entrepreneur himself; Russian cars mean savings, foreign cars mean prestige.

It is necessary to point out one more important fact: when obtaining a medical license, this can play a role; the state requires private companies to provide a high level of services. When a fleet of vehicles has been identified and purchased, you can begin to equip the mini-hospitals on wheels. Here's what should be in a standard ambulance according to legal documents Russian Federation:

Two medical boxes - the main one and with a birth and resuscitation kit.

Electrocardiograph.

Defibrillator with electrocardioscope.

Two ventilators.

Inhalation anesthesia device.

Glucose meter or glucose tests.

Tonometer and phonendoscope.

Sets of tires and head holders.

Vacuum mattress.

Two types of stretchers.

Wheel chair.

Reception device with stretcher.

Tripod and oxygen cylinder.

Aspirator and directional lamp.

In addition, a huge list of medications will be required; the work of the ambulance is fully regulated by Order of the Ministry of Health of the Russian Federation dated March 26, 1999 n 100 (as amended on June 10, 2010) “On improving the organization of emergency medical care for the population of the Russian Federation,” which specifies not only the necessary equipment of the team, but and requirements for its crew and the work of the ambulance in general. It is best to recruit personnel who have experience working directly in emergency medical services, especially for the driver, who must know and navigate the city perfectly.

In general, cars do not necessarily have to return to the base after a call; they can be dispersed throughout the city districts in order to quickly arrive at the client; the dispatcher must monitor their location. In addition to the above equipment, the vehicle must be equipped with a walkie-talkie for communication with the dispatcher and other vehicles, furniture for storing medications and bedding: pillows, a blanket, a set of linen, which ideally should be changed every time after the next call.

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An important point is the equipment of the dispatcher, whose conversations with patients must be recorded; the dispatcher must work in special program, where all data about incoming calls is entered. Both he and the ambulance team must keep strict records of the services performed, all of this is transferred to higher medical institutions within the time limits specified by law; upon receipt of a license, it will be reported to which department the documents will have to be submitted.

Now you can calculate the initial investment:

Registration of a business entity form, obtaining a license to provide services to hospital organizations, registering cars with the traffic police and obtaining permits to use a flashing light - 50 thousand rubles (it is better to have additional funds in reserve).

Rent of premises with a garage and utility bills - from 160 thousand rubles.

Purchase and equipment of cars. If you buy foreign-made cars, then 5 million will be required only for the cars themselves, while another 100 thousand will have to be invested in each for equipment - 5 million 500 thousand rubles.

Staff salaries. This is based on fifteen teams (driver, doctor, paramedic), dispatchers, chief physician, mechanic, orderlies. Such huge staff employees will require a significant material fund and will become the main expense item monthly - 1 million rubles.

Equipment for restrooms and call reception; this includes furniture, appliances, equipping the garage with the most necessary things (one box is enough for repairs), establishing communication between all employees and with all medical institutions in the city, as well as purchasing a quickly memorable phone number– 150 thousand rubles.

The total amount of starting capital should be approximately 7 million rubles. The advertising campaign should be discussed separately. The main clients of private ambulances are wealthy people who are willing to pay for quality services, so information should be conveyed to them first. These should be business cards in private and paid clinics, advertising posters in relevant medical institutions, as well as advertising around the city and on local television and radio. There is no point in conducting a full-fledged marketing campaign in municipal hospitals; everyone who could afford it has long been treated in private clinics, but leave it in government institutions information about yourself is still worthwhile - information leaflets that will cover a certain percentage of the target audience will be enough.

An important point is cooperation with insurance companies; revenue from services included in the voluntary health insurance package may exceed income from regular calls. VHI policies are now issued by many enterprises to their employees, with all expenses paid by the employer, which allows a large percentage of the population to be registered in such a program and receive free help for them. The entrepreneur will receive his funds from the insurance company, albeit with some delay, but stably. You will first have to contact all insurance companies with an offer of cooperation; if there are few competitors in the city, they will quickly enter into cooperation, but in otherwise may refuse, citing already concluded contracts. Provide your policies with several ambulance services Insurance Company He’s unlikely to want it – it’s not profitable.

In addition to the services of providing the actual emergency care patients can be given Additional services: transportation of bedridden patients, including beyond one settlement, doctor consultations, duty at various events and holidays. In the future, such a service can develop, turning into a medical consultation or even a treatment center.

Despite significant investments, such an undertaking, in the case of a competitive and competent organization, will pay off within a year or two. One ambulance team makes an average of five visits to patients per day, while in cities federal significance the amount of one call alone can reach four thousand rubles. In other cities, prices for services are much lower, but from one patient it is quite possible to receive at least two thousand rubles in net income. Thus, the monthly amount will be one and a half million rubles, operating profit - 340 thousand rubles. If you use the program simplified system taxation, then the net profit per month will be about 290 thousand rubles.

Of course, it will be possible to receive such an amount only a few months after the start, and only if the level of competition is acceptable. Without a preliminary study of the market, you can be left completely without orders, so before you start organizing a private ambulance, you should find out all the possible information about the clients and whether they fully satisfy the demand for this type of service.

Matthias Laudanum

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