A Salute to Addison County & Brandon
RESCUE WORKERS
August 2017
Front line community
(See MVAA, Page 12)
Service
By JOHN S. McCRIGHT VERGENNES — When Sara McKirryher joined the Vergennes Area Rescue Squad in August of 2000 she was around 20 years old, and she didn’t know exactly what she was getting into. “I didn’t know what to expect,” the Vergennes resident said in a recent interview. “My mom (Ann Rivers) was on the rescue squad, and she convinced me to take a healthcare CPR course and join (VARS). “I just wanted to give back to the community, do something of value,” McKirryher said. So she did the CPR training and showed up for her first night as a VARS volunteer. There were two seasoned EMTs (certified Emergency Medical Technicians) on the job with
her that night, and it turned out to be a good thing. While many shifts have two or three calls for service, McKirryher’s first shift had eight. “It was abnormally busy,” she said, with understatement. The busy pace seemed to suit McKirryher, who is now 46. She stuck with the 12-hour shifts, doing six to eight a month. And she stuck with the training, too, first earning her EMR (Emergency Medical Responder) certification, and then her EMT accreditation within two years. Today, she’s got a full-time job, and cut back to four or five shifts a month. But McKirryher, who is the current president of VARS, is still deeply involved. As an officer, (See McKirryher, Page 8)
VERGENNES AREA RESCUE Squad President Sara McKirryher is always ready to serve.
Independent photo/ John S. McCright
A special publication of The Addison Independent
PAGE 2 ~ A Salute to Addison County Rescue Workers ~ Addison Independent, Thursday, August 24, 2017
2017 ROSTER
Brandon Area Rescue Squad Darryll VanDetta Tyler Hock Bill Mapes Bob Walters Brian Porch Gideon Yeager Andy Jackson Lewis ButterďŹ eld Jeff Dayton Marc Muth Aimee Herrick Ken Dwy Jordan Martin Erin Kilpeck Robert Taylor Krystal Bowen Josh Felion Ben Herrick Stephanie Corsi Tony Lockwood Debbie Boyce Cathy Robideau Emily Jannene Jason Bates
~ A Salute to Addison County Rescue Workers ~ Addison Independent, Thursday, August 24, 2017 — PAGE 3
2017 ROSTER
Bristol Rescue Jack Beatty Grace Berg Kim Bickham Justin Bouvier Sharon Compagna Robin Cox Berend Doane Morgen Doane George Dunne Cheryl Estey Eric Forand Rich Fritz Brady Fuller Sheila Henderson Ed Hilbert Jim Hines Kelly Howard Dennis Hysko Anne Jackson Steve Jarvis John Johnston Carolyn Knight Liam Knight John Lea
Jim Logan Rick Loyer Dennis Maloney Carol Morrissey Rob Mullin Tracey Orvis Thayer Osborne Charlene Phelps Mark Rickner Dave Schantz Eleanor Scully Ronnie Sunderland Brian Wendel
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PAGE 4 ~ A Salute to Addison County Rescue Workers ~ Addison Independent, Thursday, August 24, 2017
Bristol Rescue Squad, Inc. 47 Years of Service 1970–2017 Dear Friends of Bristol Rescue, Each year at this time we appeal to you for subscriptions and donations so that we are able to continue to serve the communities of Bristol, Lincoln, Monkton, New Haven, and Starksboro. It is through your support and our dedicated volunteers that we are able to provide 24 hour emergency service to this area. Along with the Annual Subscription Service we make our emergency medical service possible through generous donations from our community. Our recent fundraiser on the 4th of July was able to raise about $2,000. Thank you to our outstanding and supportive community!
Benefits of our Annual Subscription Service:
Help Wanted: In addition to the contributions and subscriptions necessary to make our Emergency Service possible, we are always looking to add more members to the squad. For those interested in providing Emergency Service care to our friends and neighbors please stop in for one of our meetings. Our business meetings are the second Wednesday of each month and training meetings are the fourth Wednesday of each month. Our annual awards dinner, when officers are elected, will be held on Wednesday, September 13th at Rosie’s. We also have some upcoming training opportunities. We will offer an Emergency Medical Technician Basic (EMT) class starting in November. In January 2018 classes will be held on Monday and Thursday evenings. Please contact ronniesunderland@yahoo. com for more details.
Bristol Rescue Squad, Inc.
+ We bill insurance carriers for service to all patients transported. + Subscribers will not be billed personally for any amount. + Subscription can help cover policy deductibles & co-payment amounts. + Subscriptions begin September 1st. Bristol Rescue Squad, Inc. PO Box 227, Bristol, VT 05443
Please direct any questions to Ron Sunderland at 388-7052.
SUBSCRIPTION APPLICATION
℅ New England Ambulance Billing, Inc. PO Box 153 Vergennes, VT 05491 NEAB business line: (802) 877-2429/fax: 877-2292
Payment of $55.00 must accompany this application
PRINCIPAL SUBSCRIBER _______________________________________________________ FIRST
MIDDLE INITIAL
LAST
MAILING ADDRESS ____________________________________________
APT# _______________
CITY _____________________________________ STATE__________ ZIP ____ HOME PHONE_______________________
Please Include Insurance Information Medicare ID# _____________
Full name of dependents other than myself included on this subscription. Name ____________________________________________________ Name ____________________________________________________ Name ____________________________________________________ Name ____________________________________________________ Attach list of names Dependents if more space is needed.
In addition to the subscription fee, I wish to make a tax deductible donation of: $ ______________________
Medicaid # _______________ BCBS# __________________ Group # _________________ Other Insurance ___________
~ A Salute to Addison County Rescue Workers ~ Addison Independent, Thursday, August 24, 2017 — PAGE 5
Ferrisburgh First Response
Chief Dennis Rheaume / EMT Cpt. Lisa Northup / EMT Lt. Lew Castle / EMT David Guertin / EMR Jason Gagne / EMS Training Officer
Jonathan McCluskey / EMT Rich Isenberg / EMT Gail Isenberg / EMT Haley Stearns / EMT
2017 ROSTER
2017 ROSTER
Cornwall First Response
Anthony Porter Bill Wager Justin Soter
Adam Bunde Trevor Patterson
Deep Appreciation THANKS
BRANDON SQUAD
To All Rescue Workers You Are Truly Distinctive Thanks From: Dave’s Forestdale Grocery & Deli 1396 Rte 7 South Middlebury, VT
Shop Local
www.distinctivepaintvt.com 388-2500 388-2500
Furnace Road, Forestdale, VT 802-247-6457
Thank You Rescue Workers and Volunteers! Your Life-Saving Work Connects Us All. Telecommunications Sales & Service Data Cabling & Fiber Optics
John & Jim Fitzgerald
802-388-8999
www.aclepc.org • mattf@gmavt.net • rconway@shoreham.net • 349-0214
PAGE 6 ~ A Salute to Addison County Rescue Workers ~ Addison Independent, Thursday, August 24, 2017
Granville First Response Danial Sargeant, EMR Dave Winborn, EMT Nancy Shaw, EMT Dave Chase, EMT
2017 ROSTER
Gregory Millard, EMR Kerin Doyle, EMT Harley Vadnais Victor Ribaudo Brennan Bordonaro Kira Sargeant Wesley Sargeant Brian Sargeant Seamous Doyle Benjamin Smith Theodore Smith Nicholas Beattie Brianna Roussell Brandon Stone
Thank you to all our area Rescue Squads and first responders for your dedication and service to our communities.
Sanderson Ducharme Funeral Service Locally Owned and Operated 117 S. Main St., Middlebury, VT 388-2311
Thanks to all the Addison County Rescue Services Volunteers
THANKS TO OUR EMERGENCY RESPONSE TEAMS Your Work is SEW Deeply Appreciated! Thank You for Your Dedication & The Countless Hours of Training You Devote. 1428 Route 7 South Middlebury, VT 05753 802-388-3559 | middleburysewnvac.com Mon-Fri 9am-5pm, Sat 9am-1pm
WEYBRIDGE, VERMONT • 545-2119
~ A Salute to Addison County Rescue Workers ~ Addison Independent, Thursday, August 24, 2017 — PAGE 7
2017 ROSTER
Lincoln Volunteer Fire Co.
Jeff Cousino, EMR Nate Perry, EMT Eleanor Scully, AEMT Aaron Thomas, EMR Matt Atkins, EMR Dan Ober, EMT Jacqueline Olson, EMT Scott Bernoudy, EMR Steve Atocha, EMT
Insuring Emergency Service Organizations since 1969
Thank You
Addison County Rescue & First Response Squads
for your dedication to our community. We appreciate all you do! When Home is not an option…. ARCH partners with Helen Porter Rehabilitation & Nursing with 3 end of life rooms ARCH partners with Porter Hospital to provide care in The Estuary ARCH partners with Addison County Home Health & Hospice for Palliative Care and the Hospice Team ARCH partners with Hospice Volunteer Services for companioning, bereavement support and music.
www.addisonrespitecarehome.org
...a subsidiary of the Glatfelter Insurance Group
Automobile • General Liability • Management Liability Portable Equipment • Property • Umbrella Accident & Sickness • Length of Service Awards Program
GAINES INSURANCE AGENCY, INC. 154 Monkton Rd., Ferrisburgh • 877-2878 www.gainesinsurance.com
PAGE 8 ~ A Salute to Addison County Rescue Workers ~ Addison Independent, Thursday, August 24, 2017
TWO FIRST RESPONDERS wait with their Vergennes Area Rescue Squad ambulance at the tractor pad during the tractor pulling competition at Addison County Fair and Field Days earlier this month. Ambulance crews from Middlebury and Bristol were also on duty at the fair. When they weren’t tending to the needs of people at the tractor pulls, the Vergennes crews were on call at the demolition derby.
Independent photo/John S. McCright
McKirryher (Continued from Page 1) she has a monthly business meeting. And, like other rescue squad members, she goes to one or two training sessions a month. There’s a lecture to provide structure for each training session, which might give new information or be a refresher of things that squad members already have been trained to do. Then there is the practical training. “It’s really hands-on,” McKirryher said of the monthly training sessions. “Some of the stuff you do only once in awhile … Some things we don’t use a lot but we train on them so when we have to we can do them, like traction splints, which are used to relieve pain. “Or a stair chair,” she continued. “Things you may not touch for a couple shifts.” One aspect of training that McKirryher has seen increase is treatment for those afflicted by drug overdoses. VARS crew members, like other first responders across the county, learn what an opioid drug overdose looks like, and how to treat it, including with Narcan, the drug that is said to bring an overdose patient back to life after they stop breathing. McKirryher said that Narcan is fairly expensive and has a relatively short shelf life, but VARS keeps it on hand.
The rescue squad members also train with local police, who help them learn what to keep an eye out for in terms of drug abuse among patients. “The drug epidemic has hit us here but not as much as in other counties,” McKirryher said. WHAT A RESCUE SQUAD DOES VARS services encompass a broad array of activities. Some of those services include CPR classes for schools, businesses and others; child safety, such as car seat checks at its station at 106 Panton Road twice a
month on the first Thursday and the third Saturday and bicycle helmets and fittings; and response to natural disasters around the country, such as the VARS response to Hurricanes Rita in Texas and Sandy in New Jersey. It’s most high profile service — like the rescue squads in Bristol, Middlebury and Brandon — is a 24-hour ambulance service for emergency transports and emergency care
of the sick and injured. VARS is a non-profit And like those other “It makes the organization that supports agencies that have rigs, patient feel its operations mostly VARS works with volunteer through three funding rescue squads, like those in more comfortsources: 1. it bills patients Ferrisburgh, New Haven, able because it’s and their insurance for Monkton and Bridport/ services, 2. it gets grants Addison (Town Line First someone from the from towns it serves, and 3. Response). These first community who it holds fundraisers. response squads provide McKirryher said VARS, about 90 percent of the pre- helps them.” like some other agencies, hospital emergency care — Sara McKirryher, has a subscription service, in Vermont and are staffed president of VARS where local residents can by volunteers. Officials pay a certain amount per agree that there is a critical year and then if they need need for more volunteers ambulance service it is in Addison County and all over Vermont. already paid for. Several squads in Addison County have One thing McKirryher wishes that VARS hired a couple paid staff for some shifts due had is more volunteers. to shortage of daytime members. “We just took on four new members in the For those who volunteer, a first response last two months, so if we could gain five to unit provides training, organizational support seven more we would be good,” she said. and a chance to serve the community. As the Those on the rescue squad, like those on VARS website emphasizes: local first response teams, manage to balance “The most important thing we do is save their emergency services with a paying job. lives!” McKirryher, herself, has a full-time job McKirryher really appreciates what her as an accountant in an office working for partners on the local first response teams do. Green Mountain Power. She said she likes She said they are often the first on the scene the balance of the work outside in fast-paced — “Some parts of Addison and Bridport, it situations that the rescue squad provides. “Both jobs play off of each other,” she said. takes us a long time to get there,” McKirryher said — and they have the training to help “In the emergency response world we make stabilize a patient and take a history so that decisions on our feet quickly and that carries the EMR or EMT in the ambulance will have through in our jobs.” And then there is the payoff of seeing a head start when they arrive on scene. Plus, the first response squads have an clients brighten when you, the first response added benefit for people who are in pain and volunteer, show up. “When any rescue squad shows up, for the may be unsettled. “It makes the patient feel more comfort- clients there is that glimmer of hope — ‘Oh, able because it’s someone from the commu- you’re here,’” McKirryher said. nity who helps them,” McKirryher said.
~ A Salute to Addison County Rescue Workers ~ Addison Independent, Thursday, August 24, 2017 — PAGE 9
Middlebury College Emergency Response Jamie Carroll Jim Dougherty Chris Ayers Tim Parsons Ray Gale
2017 ROSTER
David Guertin Ed DeMatties Maria Farnsworth Mike Wakefield Erin Kilpeck Kimberly Bickham Tom Sullivan Dennis Rheaume Eric Leno Howie McCausland Scott Barker Derek Doucet Sean Grzyb Rick Iffland Jen Kazmierczak James Logan Curt Wemette
2017 ROSTER
Middlebury College Ski Patrol Sean Grzyb, Director Robin “Tucker” Angier, Assist. Director Daryl Morrison Sophie Leitner Emily Kohutnicki Ben Michel Maggy Mulhern Pete Kirby-Miller Philip Klinck Kaitlyn Frances Atticus Proctor Tegan Whitney Sam Ferguson Asher Brown Trevor Hopkins Danielle Fisher Will Henriques Reed Hutton Sydney Shuster Jessie Klinck Kye Moffet Caroline Daley Michael Kravitz Timothy Brendan Murphy Andrew Schwartz Spence Peterson Eli Susman Greta Hulleberg Emily Vicks Abigail Jameson Cole Ellison Eve Lablame Caroline Corbally Octave Lepinard Sarah Fossett Sam Scatchard Roger Winters Abby Jones
PAGE 10 ~ A Salute to Addison County Rescue Workers ~ Addison Independent, Thursday, August 24, 2017
2017 ROSTER
Middlebury Regional EMS Teena Betourney Ben Masterson Jonathan McCluskey Margo Reigle Bill Cotell Donnie Sweet Nicole Friend Mark Nelson David Fuller Courtney Crane David Cohen Wendy Mason Carl Leduc Richard Cota Kylie Leach Ryan Donnelly Jeff Reed Margaret Weber Ryan Emilio John Hughes Nick Iocco Matt Booska Marie Vasitas Devin Dwire Paul Miller Reid Peck Lisa Lee Will Pennington Eric Martens Fitzgerald Liz Orr Cortland Fischer Mary Miller Muriell Lavelle Peter Ochs Eddie the French Kate Ingwersen Bulldog Jamie Carroll (station dog) Kirk Gallipo Jack Beatty Marlene Ringer Josh Deppman Capricia Burbo Ron Dragon Jim Ringer Matt Abare Mike Hendrickson
Extending Our Appreciation
to all area Rescue Workers & their families for all of the time you dedicate helping and protecting our families.
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~ A Salute to Addison County Rescue Workers ~ Addison Independent, Thursday, August 24, 2017 — PAGE 11
Left to Right: Deb, Nathan, Drew, Brian & Jake
Thank You for all you do
from www.woodwarevt.net Rt. 7 South • Middlebury • 388-6297 • Hours: Monday-Saturday 9-5, Closed Sunday
Thank You from your neighbors at
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R
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ESCUE WORKER
“When the alarm goes off, almost the only
S
examples of enthusiastic unselfishness to be Your local
dealer.
seen in this land. They rush to the rescue of any human being, and count not the cost.” -Kurt Vonnegut
Thank you volunteers for keeping our community running.
JACKMAN FUELS, INC. Serving Addison Chittenden Counties Since 1945
Thank you to all Addison County Rescue Squads!
Let us help you drive safe. Stop in today!
33 Seymour Street • Middlebury • 388-7620 877-2661 • 205 Main Street, Vergennes • jackmanfuels.com
PAGE 12 ~ A Salute to Addison County Rescue Workers ~ Addison Independent, Thursday, August 24, 2017
EMS workers give Vermont so much
BURLINGTON — For National Emergency Medical Services Week and throughout the summer, communities around the state are honoring the more than 2,800 neighbors, friends and family members who stand at the ready as Vermont’s emergency medical service providers. Gov. Phil Scott in late May officially kicked off this year’s celebration with a proclamation declaring May 21 – 27 as EMS Week. Vermont Emergency Medical
Services Chief Dan Batsie said it’s difficult to underestimate the contribution EMS providers make to their communities. “Vermont’s EMS personnel are an incredibly dedicated cadre of professionals and volunteers,” Batsie said. “They work 24/7 to promote and protect public health in ways ranging from conducting infant and child car seat safety checks, to working with older Vermonters about fall prevention, to responding to individual and
community emergency situations.” “There are many people with us today who know first-hand the life and death difference EMS responders make,” he added. With many EMS units in Vermont made up of volunteers, the Health Department encourages people to visit OnCallforVT.org to learn more about serving their communities as an emergency medical technician or as a member of the Medical Reserve Corps.
Community cheer
TOWN LINE FIRST Responder Barb Wagner shows off her red, white and blue smile as she has a good time in the Vergennes Memorial Day parade this past spring.
Photo by Mark Bouvier
Volunteer! Support for MREMS
THE MIDDLEBURY LIONS Club present a check for $1,000 to Middlebury Regional Emergency Medical Services (MREMS) this past May toward their next ambulance purchase. At the check passing ceremony were, from left, MREMS President David Pistilli; Teena Betourney, MREMS Communication Director & Co-Director; Middlebury Lions President Randy Bigelow; and Lions board member Heidi Cunningham.
‘Patient’ monitor
BRANDON AREA RESCUE Squad EMT candidate Abby Lancour puts one of BARS’s new Lifepak 15 cardiac monitors on the arm of EMR David Cahill as paramedic Darryll VanDetta works the system during a training session in Brandon last week. BARS, which has three ambulances equipped at the advanced life support level, is a paramedic-licensed EMS provider responding to 911 calls in Brandon, Goshen, Leicester and Sudbury. It also provides mutual aid to Middlebury Regional EMS and Regional Ambulance of Rutland when requested. Photo courtesy of Bill Mapes
Hands-on training
CHIEF DENNIS RHEAUME applies some first aid to fellow Cornwall first responder Lisa Northup during a training session at the Route 30 firehouse in Cornwall last month.
Independent photo/John S. McCright
~ A Salute to Addison County Rescue Workers ~ Addison Independent, Thursday, August 24, 2017 — PAGE 13
2017 ROSTER
Monkton First Response
Kelly Howard Mark Rickner Rob Mullin Jeremy Steele Rick Loyer
Our Appreciation goes out to all Addison County Rescue Squads Supporting Agriculture in Addison County & Beyond Since 1988
759-2562
Jersey Street South • Addison, Vermont
PAGE 14 ~ A Salute to Addison County Rescue Workers ~ Addison Independent, Thursday, August 24, 2017
2017 ROSTER
New Haven New Haven First Response
Lisa Lauziere Kristen Hamel Dean Gilmore Barb Garrow Randy Garrow Nikki-Lyn Lauziere Stephanie Ball Joyce Garrow Eva Doane Morgan Doane Brian Fraser
BUILDING TRUST. DELIVERING RESULTS.
LUMBER & BUILDING MATERIALS • HARDWARE & HOME KITCHEN & BATH • DOORS & WINDOWS DECKING & RAILING • ROOFING & SIDING
Thank you, Addison County Emergency Responders for your help in our community.
POWER TOOLS & HARDWARE
SCUE AND THANK YOU RE ERS FIRST RESPOND ICE! RV FOR YOUR SE Exchange Street • Middlebury, VT • • rkmiles.com
SINCEREST THANKS TO ALL RESCUE WORKERS FOR A TOUGH JOB WELL DONE!
16 Creek Road, Middlebury • 388-6054 Mon. - Fri. 7:30 - 5:30, Sat. 8:00 - 3:00 www.countrysidecarpetandpaint.com
We can make their job a lot easier... ...IF WE BUCKLE UP!
~ A Salute to Addison County Rescue Workers ~ Addison Independent, Thursday, August 24, 2017 — PAGE 15
Ripton Rescue Squad
Ceredwyn Alexander, EMT Justin Allen
2017 ROSTER
Jake Codding Ron Dragon Erik Eriksen Erica Godin Jay Harrington Marty Kulczyk Will Mathis Mark Nelson Reid Peck Chris Pike
2017 ROSTER
Orwell Rescue
Peter Ochs Mary Miller Lynn Gallagher Liz Orr Jim Dougherty
Louis Hall (Charter Member) Natalie LaDuc Paul Metcalf Maria Jones
The Town of Middlebury salutes its dedicated volunteer rescue workers.
Thank you all for the commitment you show and the service you provide us! www.townofmiddlebury.org
PAGE 16 ~ A Salute to Addison County Rescue Workers ~ Addison Independent, Thursday, August 24, 2017
Shoreham First Response
2017 ROSTER
Dick Treadway Joan Treadway Bill O’Neill Rene Saenger Dave Waag Kali Waag Katie Riesterer
2017 ROSTER
Starksboro Rescue
Charlene Phelps Cheryl Estey Tracey Orvis
Dave Schantz Stephanie Machia
To volunteer contact Charlene Phelps at luvtwins@gmavt.net or 802-363-4276.
~ A Salute to Addison County Rescue Workers ~ Addison Independent, Thursday, August 24, 2017 — PAGE 17
Town Line First Response Barb Wagner Sue Stocker Ron Sunderland Jessica Torrey
2017 ROSTER
Bill Taylor Paul Miller Chuck Welch Alice Grau Paul Callicott Jess Morse Donna Woods Sue Nelson Geoff Nelson Josh Deppman Tony Korda Jennelle Boulanger
VERGENNES
REDEMPTION CENTER
Dr. Robert Austin, Optometrist
THANK YOU, LOCAL RESCUE SQUADS, FOR YOUR DEDICATION AND SERVICE
is very proud of the men & women who serve on our local
Volunteer Rescue Squads!
Open Monday 8-4, Tuesday-Friday 8-5 • Call for an appointment today!
Open 7 days a week! Monday – Saturday 5am-8pm • Sunday 7am-7pm
27 Main Street, Vergennes (802) 877-2422
877-6768 15 • Main Street • Vergennes
EMERGENCY & ROUTINE EYE EXAMS • FASHIONABLE EYEWEAR • CONTACT LENSES
J.D. FULLER PLUMBING & HEATING, INC. Service - Installation - Repairs 24-hour Emergency Service Thanks to all ambulance & first response volunteers for your sacrifice & hard work. John D. Fuller, Master Plumber
388-2019
5118 Case St. • Rt. 116 Middlebury, VT 05753
PAGE 18 ~ A Salute to Addison County Rescue Workers ~ Addison Independent, Thursday, August 24, 2017
2017 ROSTER
Vergennes Area Rescue Squad Richard Catchapaw Chelsea Ross Annie Jackson Justin Soter Niki Lauziere Allison Rimmer Sandy Korda Kelly Ashe Rick Loyer Eric Martens Jessica Torrey Josh Deppman Lisa Lauziere Sara McKirryher Chris McKirryher Steven Sickles Steve Fleming Sophia Parker Brian Fraiser Tom Leeman Justin Lafond Ashley Eriksen Brian Goodyear Nicole Friend Rik Roberts Kristen Hamel Christina Brace Richard Cota Kate Ingwersen Chuck Welch Donnie Sweet Paul Boivin
Whiting First Response
Rick Iffland
2017 ROSTER
Keith Hartline Larry Wilbur Tammy Wilbur Marie Berry Bob Wood Cody Quesnel Laura Dame Avery Thurston
~ A Salute to Addison County Rescue Workers ~ Addison Independent, Thursday, August 24, 2017 — PAGE 19
PAGE 20 ~ A Salute to Addison County Rescue Workers ~ Addison Independent, Thursday, August 24, 2017
MREMS
MIDDLEBURY-REGIONAL
Emergency Medical Services
THANK YOU for your past support of MREMS. We have been providing emergency service in Addison County for more than 4 decades. We started as a citizen-led, all volunteer organization and have evolved into a dual volunteer and career staff service. Today, MIDDLEBURY REGIONAL EMS is much more than just ambulance services. We also provide: • Paramedic-Level service • 911 Ambulance Response • First Responder services • Heavy Rescue services • Community Education • Dispatch & Answering services • Switchboard service for Porter Hospital • Ambulance billing services We are here to serve you and your family in your time of need. As a non-profit organization providing critical service to the community, we ask you to become a member to support our mission. Thank you, MREMS Staff
Membership Application
(ALSO AVAILABLE ONLINE)
Middlebury Regional EMS Annual Membership Program Membership year: July 1, 2017–June 30, 2018 Why Should You Become a Member? You never know when you or a loved one might need this critical emergency service. MREMS responds to over 2000 incidents a year, providing state-of-the-art patient care. Without this membership, your cost could exceed $1000 for 911 ambulance services. As a non-profit organization, MREMS needs your support. Subscription Plans: $60 Single: a single person who has no other persons living in the household. $70 Double: two people living at the same physical address. $85 Family: all people living at the same physical address, including all legal dependents. Business: The business must be registered with the state of Vermont. Minimum of 5 employees for this membership. Cost per employee $45. Membership applies to resident and business subscribers who live and work in the 10 towns we service: Middlebury, East Middlebury, Bridport, Cornwall, Orwell, Ripton, Salisbury, Shoreham, Weybridge, Whiting, and parts of New Haven. We bill your insurance company directly. Your membership is not an insurance policy— it covers any outstanding fees that your insurance carrier does not cover.
Name (primary member or business): __________________________________________________________ Mailing Address: __________________________________________________________________________ Phone: __________________________________________________________________________________ Please list names of household or business members to include in membership: ________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________
Membership $60 Single
$70 Double
$85 Family
Business: $45 per employee Total # of employees ________ X $45/per employee = $ ___________ I would like to include an additional donation of $______________towards the purchase of a new ambulance Payments can be made by check payable to MREMS, or by Visa or Mastercard. MREMS reserves the right to any third-party billing. All program fees are tax deductible – a copy of your application is your receipt. Method of payment Check #_______________
MasterCard Visa Card # __________________________________________________________________________________ Expiration date: ________________________________________ 3 or 4 digit security code ______________ Cardholder Name _________________________________________________________________________ Billing address (if different from above) ________________________________________________________ _______________________________________________________________________________________ Signature _________________________________________________ Date: _________________________ MREMS respects your privacy. We will not share any of your information with 3rd parties.
Questions? Call 388-3286 • www.middlebury911.org
Membership is valid form July 1, 2017 to June 30, 2018 and must be renewed annually.
MEMBERSHIP AGREEMENT TERMS I hereby apply for the Middlebury Regional EMS (MREMS) service subscription membership program as indicated on the reverse side of this form. I understand that the indicatedfee provides local emergency ambulance services to members and their registered associates as indicated and qualified, and as determined to be medically necessary within the service area of MREMS at no additional cost during the time of the prescribed agreement (MREMS fiscal year period of July 1 to June 30). I also understand that this membership permits MREMS to collect directly from any third party agency whatever benefits may be available at no charge to me, my family, or my constituents, and that this membership is non-refundable and non-transferrable. I request that any payment of any authorized insurance benefits be made on my behalf to MREMS for any services furnished by this health care provider or supplier. I authorize any holder of medical information about me to be released to the Health Care Financing Administration and its agents any information needed to determine these benefits payable for related services. Signature ____________________________________ Date ________________________________________
Send form & payment to: MREMS Attn: Subscription Membership 55 Collins Drive, Middlebury VT 05753 (802) 388-3286 • (802) 989-7245 Fax