Book Ambulance Rental | Patient Transfer

Western Pacific EMS

Book Online

Name of Person Requesting

First Last

Your Email

Your Phone Number

Patient Weight in LBS

Are there any access barriers (stairs, etc)

Stairs with no elevator or ramp

Narrow doorways or hallways

Steep driveways or uneven paths

Lack of handrails

No designated drop-off zone

Gravel or unpaved surfaces

Limited lighting or signage

Restricted parking or no accessible parking nearby

Transfer From

Transfer To

Date of Transfer

Appointment or Pick Up Time

Is this a one way transfer, or return after appointment?

Please let us know any additional information about your request, special needs, access or care requirements. This information will be relayed by our dispatch to the patient transfer crew:

Our Patient Transfer Booking Office is available from 8:AM to 4:PM Monday to Friday, Pacific Standard Time. Once we receive your request, we will review it and calculate the cost of the medical transport and will contact you to confirm acceptance of the patient transfer request. If you require after hours service, please email info@pacific-ems.com and we will respond as able.

All pre-scheduled patient transfers are conducted on a private pay basis and payment is required in advance.