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+1 (321) 297-1666
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Our mission is to provide affordable and quality care in medical & patient care transport. We understand the decision to hire a private ambulance transport service can be daunting, however we ensure complete coordination bedside-to-bedside alleviating as much stress as possible for you and your loved ones. We even allow passengers and pets to ride along.
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Booking Information
Service Date:
*
Service Time:
*
Business Hours (05:00 AM – 7:00 PM) –
$0.00
After Hours (7:00 PM – 05:00 AM) –
$25.00
Pickup Time:
*
Select time
5:00 AM
5:30 AM
6:00 AM
6:30 AM
7:00 AM
7:30 AM
8:00 AM
8:30 AM
9:00 AM
9:30 AM
10:00 AM
10:30 AM
11:00 AM
11:30 AM
12:00 PM
12:30 PM
1:00 PM
1:30 PM
2:00 PM
2:30 PM
3:00 PM
3:30 PM
4:00 PM
4:30 PM
5:00 PM
5:30 PM
6:00 PM
6:30 PM
After Hours:
*
Select time
7:00 PM
7:30 PM
8:30 PM
9:00 PM
10:30 PM
11:00 PM
11:30 PM
12:00 AM
12:30 AM
1:00 AM
1:30 AM
2:00 AM
2:30 AM
3:00 AM
3:30 AM
4:00 AM
4:30 AM
Select Service:
*
Select service from drop down
1 Wheelchair
2 Wheelchairs
Stretcher
Passenger Name:
*
Weight:
*
Please enter weight in pounds
Additional Passenger(s):
*
No
No
1
2
3
4
5
Pickup Location:
*
(Location’s Address)
Terminal
Room
Suite
Apt
Other details
Drop-Off Address:
*
Terminal
Room
Suite
Apt
Other details
Dead miles:
*
Trip Distance:
*
Distance is showing in miles
Trip:
*
One-way
Roundtrip
3 Legs Trip
3rd Address:
*
(Location’s name or Address)
Leg Distance:
*
Drop-off – Drop-off (in miles)
Total Distance:
Distance is showing in miles
Wait Time:
*
No
No
1hr
2hrs
3hrs
4hrs
Rush fee:
Yes
No
Note:
Requested by:
*
Name
Phone #:
*
Email:
*
Rate:
Price:
$0.00
After Hours fee
:
$25.00
Coupon
Apply
Total:
$0.00
Secure Payment:
*
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