EMSAcare Express Checkout Member ID 5-8 charactersName(Required) First Last Email(Required) Phone(Required)Eastern Division or Western Division?(Required)Eastern Division (Tulsa Metro Area)Western Division (Oklahoma City Metro Area)By submitting this form:(Required) I acknowledge that my insurance provider and/or I am responsible for payment of ambulance services provided to me by EMSA.Please review the full membership agreement here.By submitting this form:(Required) I acknowledge that my membership will expire on August 31, 2024.By submitting this form:(Required) I acknowledge that my membership will expire on September 30, 2024.
