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Forms

Free Services

The District offers simple online forms to submit insurance info, request medical records, apply for aid, and file Crime Victims' Compensation claims securely.

Forms

Main Contact

Main Location

Administration Office:

3131 Rock Creek Rd. High Ridge, MO 63049

Administration Hours:

8:00am - 4:00pm

​

Operational Personnel:

24/7, 365 Days

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The District aims to provide simple resources to the community for submitting insurance information, requesting medical records, applying for financial assistance, and filing a claim through the Crime Victims' Compensation Program. Use our online forms to send information quickly and securely.

Station #1:

3131 Rock Creek Rd. High Ridge, MO 63049

Station #2:

1130 Gravois Rd, Fenton, MO 63026

Administration Hours:

8:00am - 4:00pm

​

Operational Personnel:

24/7, 365 Days

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© 2024 North Jefferson Ambulance District

All rights reserved.

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