Form Center

By signing in or creating an account, some fields will auto-populate with your information.

Passport to Care Interest Form

  1. Schertz EMS Passport to Care

    For a very low annual cost, you and your family can now have peace of mind knowing if you ever have to call 911 for a medical emergency, there could be absolutely no out-of pocket costs for the care and transportation that would be provided by Schertz EMS.

    As a member with health insurance, any payment received from insurance will be considered as payment in full. This benefit means no out-of-pocket costs for ambulance transportation provided by Schertz EMS.

    Please fill out the following information if you are interested in becoming a Passport to Care member. Upon completion you will be contacted to complete your membership.  If you prefer to complete the registration process over the phone, please call 210-619-1450 after submitting this renewal.

  2. Electronic Signature Agreement*
    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
  3. Leave This Blank:

  4. This field is not part of the form submission.