To ensure safety and convenience of the users, the TFD enacted the Act Concerning the Private Ambulance Service Operators Certified by the Tokyo Fire Department, according to which private ambulance service operators are certified by the TFD. Following the Act, the TFD ensures the quality of the certified operators through holding seminars for the drivers, vehicle inspection etc.

The TFD also concluded an agreement with the Tokyo Private EMS Call Center Steering Council on the guideline concerning the patient transport service in emergencies, to make up for the shortage of ambulances in large scale, mass casualty incidents.