Del Norte Ambulance Ground & Custom  Air Service

                                                        
D.N.A. Transportation Membership

          Del Norte Ambulance Ground and Custom Air Service provides a membership program, with this program,
members are not required to pay their co-payment after the deductible for your insurance has been met,
  that means NO OUT OF POCKET EXPENSES!!!. Standard price of a 1 year membership is $20.00.  
    Membership includes all family members that live in your home and are on your current insurance policy.
Coverage is limited to Del Norte Ambulance ground and emergency air services only. 

 No other ambulance service covers both 911 response and air ambulance service within Del Norte County.

Memberships forms are available at:
Del Norte Ambulance Headquarters located at 2600 Moorehead Rd., Fort Dick, CA. 95548
By Phone (707) 487-1116
Online Registration- We are unable to bill online. Billing will be done by mail or telephone.



On-Line Membership Application

First name:
Last name:
SSN#
DOB:
Email address:
Company (optional):
Address 1:
Address 2:
City:
State:
Zip code:
Phone:
Dependant Name:
DOB:
Dependant Name:
DOB:
Dependant Name
DOB: