We offer two methods of enrollment currently:

1. Use the online form below to let us know how and when to contact you for enrollment and payment over the phone, or
2. Open a PDF of our enrollment brochure, then complete the form and mail or fax it with your payment information.


Open the Neighbors for Life enrollment brochure (PDF, 416 Kb)

Secure, online enrollment is not available now but we will offer this option in the future.

By enrolling in the Ada County Paramedics Neighbors for Life program, I accept the following:

Statement of Understanding

• I understand that the Ada County Paramedics (ACP) Neighbors for Life (N.F.L.) membership program benefits me, my spouse, and my dependents that can be claimed on my income tax returns.
• I hereby apply for membership for me and my family members listed on this application. N.F.L. covers husband and wife and unmarried, dependent children under the age of 21. Your child is a dependent if you claim him or her as a dependent on your income tax return. If you do not, a separate membership is necessary, even if the child lives at your residence.
• I transfer directly to ACP my rights to insurance payments due me for billed ambulance services. The N.F.L. program covers treatments and transports that are medically necessary as defined by the Centers for Medicare and Medicaid Services. Necessity is determined by ACP or another third party recognized by ACP.
• My benefits take affect 48 hours after my payment and completed enrollment form are received by ACP.
• My membership fees are non-refundable and non-transferable. Either party can cancel my membership at any time for any reason.
• If I don’t have health insurance, I will be responsible for a per-incident fee of $100, in addition to the annual membership fee.
• ACP will accept payment from insurance carriers as payment in full.  I understand that I am responsible for insurance deductibles.
• In the event the member's insurance provider denies the claim, or if the member has no insurance coverage, the member/patient will owe no more than $100 for medically necessary responses.
• Members who receive non-transport services (treat & release) not covered by insurance will owe no more than $100 for medically necessary responses.
• I understand that this membership provides for emergency medical care and transportation. I also understand that N.F.L. membership is not insurance, but is in addition to and secondary to any insurance or medical benefits I may have.
• ACP transports patients based on medical need, not membership status, and transports patients to the closest, medically appropriate facility.
• N.F.L. applies to 9-1-1 emergency medical services (EMS) only, not non-emergency transfer services.

Please be advised

• If you have questions regarding your personal insurance coverage, please contact your insurance provider.
• N.F.L. is not an insurance program.  It will not compensate or reimburse another ambulance company that provides EMS services.
• Personal information I provide is confidential and for business purposes only. It will not be shared by ACP with any other organization except as needed to collect insurance payments.
• For questions regarding N. F. L. please call us at (208) 287-2950.

Member acknowledges all rules and guidelines pertaining to the membership.

Enrollment Form

To pay by Visa or Mastercard, complete the following form and click "Send." We will receive your enrollment information minus credit card information via e-mail, then contact you for payment over the phone. Secure, online payments will be available in the future. Alternatively, you may call Member Services, 208-287-2950, during office hours: Monday through Friday, 8 a.m. to 5 p.m.