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Membership Application
Print this application and send with your check to support your local ambulance
For $45 per year, you and family members living with you are covered for the cost of an emergency ambulance transport for one year. Coverage runs from within our response area to Mendocino Coast District Hospital or to other tertiary facilities as determined by your physician.
The membership covers that portion of the cost of ambulance service which is not covered by your insurance, or the bill in its entirety, if you are uninsured or the claim is denied by your carrier.