To Join or Update Your Participation:

Download and complete Reciprocal Participant Information Form below.
Download and complete Reciprocal Selection Form below.
Download and sign Contract below.
Prepare ASA map, Terms of Agreement and brochure.
Email all documents (preferred) or mail hardcopies of documents you cannot email:

Springfield Fire & Life Safety ATTN: Bart Noll
225 Fifth Street
Springfield OR 97477

To download sample membership application form, FireMed logo, ground ambulance coverage maps, and other related information, go to the Forms, Logos, Etc. Page

Reciprocal Participant Information Form	PDF Version	MS Word Version
Reciprocal Selection Form	PDF Version	MS Word Version
Ambulance Membership Reciprocal Agreement	PDF Version
Appendix A - Reciprocal Participants List	See sidebar link	See sidebar link
Interagency Reciprocal Agreement (If you wish to reciprocate only with Oregon Public Agencies)	PDF Version

Ambulance Administrative Services
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