Step 1: Select Payments
Step 2: Review and Submit
Step 3: Confirmation and Receipt
Step 1: Select Payments

If you are a Confederated Tribes of Grand Ronde Tribal Member, please click HERE to submit your application.

Please complete the FireMed Registration and Payment information below. When finished, click the Continue button and you will be asked to review the information for accuracy before you process.

All memberships are valid through October 31 of the upcoming year, and apply to residents served by The Grand Ronde Tribal Emergency Services Department.

If you have questions, please call 800-238-9398

Residents of the Grand Ronde Tribal Emergency Services Department service area (Willamina and Grand Ronde) pay $75 a year for the entire household.

Please provide your name (first, middle initial, last) and date of birth, along with the name and dates of birth, of a

Note: * indicates a required field.

My Bills
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Primary Member
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Middle Initial: *
Last Name: *
Date of Birth: *
Home Address: *
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Zip: *
Phone Number: *
Email Address: *

Mailing address different than your home address?
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Other Household Members
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Date of Birth:
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Date of Birth:
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Cardholder Information
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Last Name: *
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Email Address: *

Payment Information
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Expiration Date: * (in mm/yy format)