SW Polk Fire District

FireMed Registration


EMS Billing Services

(800) 238-9398

P.O. Box 3510

Silverdale,WA 98383

swpolkfiremed@emspatient.com





Who is covered?

The SW Polk FireMed program covers the entire family, which means the primary member, spouse or domestic partner, and all relatives (by blood or marriage) living in the home. Please refer to the Terms of Agreement for the full definition of covered persons.

To download a copy of the SW Polk FireMed informational brochure click HERE.

What is covered?

FireMed covers ambulance transport to the nearest appropriate hospital and medically-necessary transfers from one hospital to another that require basic or advanced life support care from an Emergency Medical Technician. One of the following conditions must be present in order to be covered by this plan:
1. The patient requires medical care.
2. The patient requires stretcher services.
3. The patient and/or family member feels that an emergency medical condition exists.
 
The ambulance may be used as many times as medically necessary.

SW Polk FireMed Rates

Please refer to the Terms of Agreement for a map of the area to determine rates.

SW Polk Fire District (ASA 2):
$75 per household

Polk County Portion of Amity Fire District (ASA 2):
$95 per household
($20.00 goes to local fire district)

Online Application and Payment

Credit Card/Debit Card/eCheck
coming soon
 

How to Become A Member?

Please complete an application and enclose a check or credit/debit payment information.

Apply by Mail
You may download and fill out the application form to the right, then including a check made out to the 'SW Polk FireMed', mail it to:

SW Polk - FireMed
PO Box 3510
Silverdale, WA 98383


Apply by Fax
You may download and fill out the application form to the right, then fax it to (360) 697-1659.  Make sure to include your payment information at the bottom of the application.
 
Apply by Email

You may download and fill out the application form to the right, then scan and email it to:
swpolkfiremed@emspatient.com

NOTE:  Submission of an application and payment constitutes acceptance of the FireMed Terms of Agreement which is available for download HERE.


How to Contact Us

For more information, please contact our billing department at the phone number, fax number or email address provided below:

1) Call our billing service department at (800) 238-9398. Please indicate that this is regards to FireMed.

2) Email any questions you may have concerning FireMed to the following email address:
swpolkfiremed@emspatient.com *

* Communications via unencrypted e-mail are not secure. Please do not include personal identifying information or medical information in any e-mail you send to us.


3) Fax completed application with payment information to the SW Polk - FireMed billing service department: Fax # (360) 697-1659.