{"title":"2027 Jericho Options","description":"\u003cp\u003eSubscriber living in Jericho may subscribe to just Essex Rescue, or to both Richmond Rescue and Essex Rescue for an additional fee. \u003c\/p\u003e\n\u003cp\u003eSimply click on your selection to be taken to the enrollment form.\u003c\/p\u003e","products":[{"product_id":"2027-essex-rescue-subscription","title":"2027 Essex Rescue Subscription","description":"\u003cp class=\"MsoNormal\" style=\"line-height: normal;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003c\/span\u003e\u003cspan style=\"color: rgb(0, 0, 0); font-family: 'Times New Roman', serif; font-size: 9pt;\"\u003eI hereby apply for an Essex Rescue subscription, covering all permanent residents living within my household and who are listed in this agreement. I understand that the subscription fee for the plan I selected is per household, \u003c\/span\u003e\u003cspan style=\"color: rgb(0, 0, 0); font-family: 'Times New Roman', serif; font-size: 9pt;\"\u003eis not prorated\u003c\/span\u003e\u003cspan style=\"color: rgb(0, 0, 0); font-family: 'Times New Roman', serif; font-size: 9pt;\"\u003e, and covers unlimited medically \u003c\/span\u003e\u003cspan style=\"color: rgb(0, 0, 0); font-family: 'Times New Roman', serif; font-size: 9pt;\"\u003enecessary\u003c\/span\u003e\u003cspan style=\"color: rgb(0, 0, 0); font-family: 'Times New Roman', serif; font-size: 9pt;\"\u003e \u003c\/span\u003e\u003cspan style=\"color: rgb(0, 0, 0); font-family: 'Times New Roman', serif; font-size: 9pt;\"\u003eemergency care\u003c\/span\u003e\u003cspan style=\"color: rgb(0, 0, 0); font-family: 'Times New Roman', serif; font-size: 9pt;\"\u003e, to me and any permanent \u003c\/span\u003e\u003cspan style=\"color: rgb(0, 0, 0); font-family: 'Times New Roman', serif; font-size: 9pt;\"\u003eresident(s) \u003c\/span\u003e\u003cspan style=\"color: rgb(0, 0, 0); font-family: 'Times New Roman', serif; font-size: 9pt;\"\u003elisted as household \u003c\/span\u003e\u003cspan style=\"color: rgb(0, 0, 0); font-family: 'Times New Roman', serif; font-size: 9pt;\"\u003emember(s) \u003c\/span\u003e\u003cspan style=\"color: rgb(0, 0, 0); font-family: 'Times New Roman', serif; font-size: 9pt;\"\u003eliving within \u003c\/span\u003e\u003cspan style=\"color: rgb(0, 0, 0); font-family: 'Times New Roman', serif; font-size: 9pt;\"\u003eEssex Rescue’s primary \u003c\/span\u003e\u003cspan style=\"color: rgb(0, 0, 0); font-family: 'Times New Roman', serif; font-size: 9pt;\"\u003eservice\u003c\/span\u003e\u003cspan style=\"color: rgb(0, 0, 0); font-family: 'Times New Roman', serif; font-size: 9pt;\"\u003e area\u003c\/span\u003e\u003cspan style=\"color: rgb(0, 0, 0); font-family: 'Times New Roman', serif; font-size: 9pt;\"\u003e.\u003c\/span\u003e\u003cspan style=\"mso-spacerun: yes;\"\u003e  \u003c\/span\u003e\u003cu style=\"color: rgb(0, 0, 0); font-family: 'Times New Roman', serif; font-size: 9pt;\"\u003eI understand that this agreement only applies to emergency medical services provided by Essex Rescue between January 1, 2027 and December 31, 2027\u003c\/u\u003e\u003cspan style=\"color: rgb(0, 0, 0); font-family: 'Times New Roman', serif; font-size: 9pt;\"\u003e. This subscription is terminated if the subscriber provides dishonest information or moves outside Essex Rescue's primary service area. I understand that as a subscriber, Essex Rescue will bill the patient’s medical insurance for services rendered by Essex Rescue and any remaining balance not covered by insurance will be waived per the terms of this agreement. I understand that this subscription permits Essex Rescue, Inc. to collect directly from any third-party agency whatever benefits may be available at no charge to me or my household members, and that this subscription is nonrefundable and is nontransferable. I request payment of authorized Medicare benefits and\/or other insurance benefits be made on my behalf to Essex Rescue, Inc., whether in the past, present, or in the future. I authorize any holder of medical information about me or other relevant documentation about me to be released to Centers for Medicare and Medicaid Services and its agents and contractors, any and all appropriate third-party payers, whether in the past, present or in the future. I understand that any insurance payment received directly by the patient from their insurance company for services provided by Essex Rescue must be surrendered to Essex Rescue. \u003c\/span\u003e\u003cb style=\"color: rgb(0, 0, 0); font-family: 'Times New Roman', serif; font-size: 9pt;\"\u003eFor emergency services to be covered under the 2027 Subscription Terms, I understand that Essex Rescue must have received a completed and signed 2027 Agreement form with full payment in advance of any provided services \u003c\/b\u003e\u003cspan style=\"color: rgb(0, 0, 0); font-family: 'Times New Roman', serif; font-size: 9pt;\"\u003ePartial year subscriptions will not be prorated to remaining subscription months. Essex Rescue does not provide business subscriptions. Any check received from a business will be considered a donation unless household members are listed as residents of the address listed.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp class=\"MsoNormal\" style=\"line-height: normal;\"\u003e\u003cspan style=\"font-size: 9pt; font-family: 'Times New Roman', serif; color: rgb(0, 0, 0);\"\u003eAny amount paid in addition to the subscription fee will be recorded as a donation and is greatly appreciated. Gifts and donations to Essex Rescue, a 501 (c)(3) non-profit organization, are tax deductible within the limits of federal and state laws. Essex Rescue does not provide goods or services as whole or partial consideration for any donations or gifts. Please keep the yellow copy of this form for your tax records along with your canceled check or bank statement.\u003c\/span\u003e\u003c\/p\u003e","brand":"Essex Rescue VT","offers":[{"title":"Default Title","offer_id":46308861476908,"sku":"EssexRescueSub-70","price":70.0,"currency_code":"USD","in_stock":true}],"thumbnail_url":"\/\/cdn.shopify.com\/s\/files\/1\/0585\/9252\/6380\/files\/EssexOnly.png?v=1790709645"},{"product_id":"2027-essex-richmond-rescue-subscription","title":"2027 Essex Rescue \u0026 Richmond Rescue Subscription","description":"\u003cp class=\"MsoNormal\" style=\"line-height: normal;\"\u003e\u003cspan style=\"font-size: 9pt; font-family: 'Times New Roman', serif; color: rgb(0, 0, 0);\"\u003eI hereby apply for an Essex Rescue subscription, covering all permanent residents living within my household and who are listed in this agreement. I understand that the subscription fee for the plan I selected is per household, is not prorated, and covers unlimited medically necessary emergency care, to me and any permanent resident(s) listed as household member(s) living within Essex Rescue’s primary service area.\u003cspan style=\"mso-spacerun: yes;\"\u003e  \u003c\/span\u003e\u003cu\u003eI understand that this agreement only applies to emergency medical services provided by *Essex Rescue between January 1, 2027 and December 31, 2027\u003c\/u\u003e. This subscription is terminated if the subscriber provides dishonest information or moves outside Essex Rescue's primary service area. I understand that as a subscriber, Essex Rescue will bill the patient’s medical insurance for services rendered by Essex Rescue and any remaining balance not covered by insurance will be waived per the terms of this agreement. I understand that this subscription permits Essex Rescue, Inc. to collect directly from any third-party agency whatever benefits may be available at no charge to me or my household members, and that this subscription is nonrefundable and is nontransferable. I request payment of authorized Medicare benefits and\/or other insurance benefits be made on my behalf to Essex Rescue, Inc., whether in the past, present, or in the future. I authorize any holder of medical information about me or other relevant documentation about me to be released to Centers for Medicare and Medicaid Services and its agents and contractors, any and all appropriate third-party payers, whether in the past, present or in the future. I understand that any insurance payment received directly by the patient from their insurance company for services provided by Essex Rescue must be surrendered to Essex Rescue. \u003cb\u003eFor emergency services to be covered under the 2027 Subscription Terms, I understand that Essex Rescue must have received a completed and signed 2027 Agreement form with full payment in advance of any provided services. \u003cspan style=\"mso-spacerun: yes;\"\u003e \u003c\/span\u003e\u003c\/b\u003ePartial year subscriptions will not be prorated to remaining subscription months. Essex Rescue does not provide business subscriptions. Any check received from a business will be considered a donation unless household members are listed as residents of the address listed.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp class=\"MsoNormal\" style=\"margin-bottom: 0in; line-height: normal;\"\u003e\u003cspan style=\"font-size: 9pt; font-family: 'Times New Roman', serif; color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"mso-spacerun: yes;\"\u003e \u003c\/span\u003e* These subscription terms also apply to eligible Jericho residents living within Essex Rescue’s primary service area who elect and pay for dual subscription coverage for EMS services provided by Richmond Rescue and Essex Rescue. \u003c\/span\u003e\u003c\/p\u003e\n\u003cp class=\"MsoNormal\" style=\"margin-bottom: 0in; line-height: normal;\"\u003e\u003cspan style=\"font-size: 9pt; font-family: 'Times New Roman', serif; color: rgb(0, 0, 0);\"\u003e \u003c\/span\u003e\u003c\/p\u003e\n\u003cp class=\"MsoNormal\" style=\"margin-bottom: 0in; line-height: normal;\"\u003e\u003cspan style=\"font-size: 9pt; font-family: 'Times New Roman', serif; color: rgb(0, 0, 0);\"\u003eAny amount paid in addition to the subscription fee will be recorded as a donation and is greatly appreciated. Gifts and donations to Essex Rescue, a 501 (c)(3) non-profit organization, are tax deductible within the limits of federal and state laws. Essex Rescue does not provide goods or services as whole or partial consideration for any donations or gifts. Please keep the yellow copy of this form for your tax records along with your canceled check or bank statement.\u003c\/span\u003e\u003c\/p\u003e","brand":"Essex Rescue VT","offers":[{"title":"Default Title","offer_id":46308874584108,"sku":"EssexRichRescueSub-85","price":85.0,"currency_code":"USD","in_stock":true}],"thumbnail_url":"\/\/cdn.shopify.com\/s\/files\/1\/0585\/9252\/6380\/files\/EssexandRichmond-JerichoOnly.png?v=1790702149"}],"thumbnail_url":"\/\/cdn.shopify.com\/s\/files\/1\/0585\/9252\/6380\/collections\/Town_of_Jericho.png?v=1790707478","url":"https:\/\/essexrescue.org\/collections\/2025.oembed","provider":"Essex Rescue VT","version":"1.0","type":"link"}