Request Ambulance Transport

Share the non-sensitive trip details below. Preferred EMS dispatch will follow up to review the request.Use this form to request BLS, ALS or MICU ambulance transportation in Greater Houston. Preferred EMS dispatch is available 24/7 and will follow up to confirm the request.

Call Dispatch(713) 791-9000

Requester Information

Requester Name

Healthcare Facility / Organization(optional)

Callback Phone

Email(optional)

Transport Details

Pickup Location / Facility

Destination Location / Facility

Requested Transport Date(optional)

Requested Transport Time(optional)

Level of Care

Additional Transport Notes(optional)

Privacy notice: For patient privacy, do not enter diagnoses, medical records, Social Security numbers, insurance IDs, or other sensitive medical information in this website form. Our dispatch team will obtain any necessary patient information through the appropriate secure process.

Or call (713) 791-9000

WhatsAppInternational Assistance

For international callers and airport transport coordination.

+1 (713) 791-9000

Required fields. Submitting this form does not guarantee transport availability or a specific response time. Our dispatch team will contact you to confirm scheduling.