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Membership offers peace of mind for unexpected emergency transport expenses. Benefits cover you, your spouse or domestic partner and dependents claimed on your income tax. Elderly or disabled family members living in the same household are also covered. If transported, we simply bill your insurance. There are no deductibles and no extra co-pays. Canby Fire Department will provide the member with a 20% discount off its regular rate for ambulance services in the event of a Canby Fire Department transport if the member has no applicable insurance. Benefits do not apply for transports lacking medical necessity. $500.00 maximum benefit per member of household per membership year.

Your membership fees help enhance EMS services in Canby by allowing us to invest in the latest life-saving equipment and highly skilled personnel. Thank you for supporting our local EMS agencies.

Your FIREMED BASIC membership covers you and your household in over 64,500 square miles of Oregon. Your FIREMED PLUS membership includes all FireMed Basic services as well as air medical transport coverage in over 200,000 square miles of Life Flight Network’s service area throughout the Pacific Northwest and Intermountain West.

By becoming a FireMed member, you agree to the terms stated in the Statement of Understanding. New member benefits take effect 72 hours after receipt of completed application and payment. Life Flight Network transports patients based on medical need, not membership status. Medicaid beneficiaries should not apply for membership.

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Membership Information

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Canby FireMed BASIC Canby FireMed PLUS
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By selecting the auto renew option, I authorize Life Flight Network to make annual recurring payments to the credit card provided. See further details at bottom of this form.**

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Member Information

Primary Member First Name* You must enter a first name.
Last Name* You must enter a last name.
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Phone*You must supply a phone number.
Email*You must provide an email address.

(Will be used to provide confirmation of membership payment as well as sign you up for our membership Enewsletter)


Dependents are defined as unmarried dependents you claim on your income tax return.
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Please call our membership office if you have additional dependents to add.

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Other Information

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Payment Information

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Please press PROCEED TO PAYMENT only once to ensure proper processing of your information. Clicking "Proceed to Payment" will redirect you to Life Flight Network's secure payment system, where you can complete your order using your credit card or PayPal account. Membership purchases are non refundable and non transferable.

**If renewing membership automatically: I hereby authorize my financial institution to make annual recurring payments from the credit card account listed above up to 1 month prior to my expiration date in the amount indicated on this form for a 1 year membership. I will notify Life Flight Network in writing if I decide to discontinue this service or change or close my credit card account. I certify that I am an authorized user of this credit card and will not dispute the scheduled payments with my credit card company provided the transactions correspond to the terms indicated in this authorization form.