Click Here! Update your Agency Information

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New Agency Registration Information

To include your agency in our database please read the following and complete an agency and program application.

The form has several sections. You may find that you need to make copies of certain pages of the form in order to include all the information about your agency. Please review the entire form before beginning the process. Make certain that you have all the information and complete all sections. Once you have complete the form you can either mail it to:

Shannon Farmer
Huron Valley Ambulance
1200 State Circle
Ann Arbor, MI 48108

or fax it to:

734-477-6418
Attn: Shannon Farmer

You will need Adobe Reader to open it.  If you do not already have Acrobat Reader, you can download it free from Adobe Systems.