Membership Application ⇽ Basic Ambulance Membership

		Unit Price	Total
Total %
Basic Ambulance Membership This is a 12-month membership This membership is for individuals only AF&R Members Are Totally Covered. One small fee. One full year. Your whole family. AF&R Basic: Emergency Ground Ambulance Services $66/yr Membership Benefits Include: Emergency prehospital, medical treatment and transportation. Emergency paramedic rescue. Emergency ambulance transportation to all local hospitals. Automatic insurance billing service.	$0

Unit Price

Total

Total %

Basic Ambulance Membership

This is a 12-month membership

This membership is for individuals only

AF&R Members Are Totally Covered. One small fee. One full year. Your whole family.

AF&R Basic: Emergency Ground Ambulance Services $66/yr

Membership Benefits Include: Emergency prehospital, medical treatment and transportation.
Emergency paramedic rescue.
Emergency ambulance transportation to all local hospitals.
Automatic insurance billing service.

Membership Refund Policy

Ashland Fire & Rescue's Ambulance Membership is non-refundable.
All members who live in the same household are covered under this one membership.
This receipt serves as your membership confirmation. You will not receive a card from AF&R.
If you are a "PLUS" member, Mercy Flights will send you a member card for the air transport portion of your coverage.

Password must be a minimum of 8 characters and contain at least one upper case letter, one lower case letter, one number, and one special character(!"#$%&'()*+,-./\:;?@[]^_`{|}~=).