Sierra Madre, CA · Los Angeles County
Paramedic Subscription Program (Residential)
Sierra Madre residents use this application to enroll household members in the city’s paramedic subscription program and agree to its terms.
What this form is
This application enrolls eligible Sierra Madre residents and permanent household members in the City’s paramedic subscription program. It asks for subscriber and household information, a household-size selection, an authorized member’s signature, and the date. Applicants agree to the program terms, including that membership begins when the Fire Department receives payment and applies to eligible emergency services within city boundaries.
Who needs it
Sierra Madre residents seeking paramedic subscription coverage for themselves or enrolled permanent members of their household should complete this application.
How to submit it
Payments may be made in person at City Hall or mailed to the Sierra Madre Fire Department. For additional information, contact the Fire Department at 626-355-3611 or [email protected].
About notarization
This document is signed and dated without a notary; the signer just signs and dates the application.
How to submit this form
- 1
Download The Application
Download the residential paramedic subscription application.
- 2
Complete Subscriber Information
Provide subscriber and household information, select the household size, and list additional members for new enrollment.
- 3
Review And Sign
Read the program agreement, then have an authorized member sign and date the application.
- 4
Make Payment
The document says payment may be made in person at City Hall or mailed to the Sierra Madre Fire Department.
Frequently asked questions
- Do I need a notary for the residential paramedic subscription application?
- No. This application is signed and dated without a notary; the signer just signs and dates the application.
- How do I submit the residential paramedic subscription application?
- The document says payments may be made in person at City Hall or mailed to the Sierra Madre Fire Department. Contact the Fire Department for additional information.
- Who can enroll in the program?
- The document says participants must be residents of Sierra Madre. Applicants can list permanent household members they wish to enroll; households outside city boundaries are not eligible.
- What information does the application ask for?
- It asks for subscriber and household information, a household-size selection, and an authorized member’s signature and date. It also includes the program agreement and emergency notification signup options.
Need something notarized?
This Paramedic Subscription Program (Residential) doesn’t need a notary — but if you have another Sierra Madre form that does, a commissioned online notary can help.