Express Reservation Form

Request a Quote General Information

Please fill out the following form to request a quote, or for general information.

Amera Solutions
Amera
Medical Coordination
& Transportation Contact Us Today

  • Express Reservation

    Please use our Express Reservation if you are a returning client. For new clients or needing quotes please use our contact page or LIVE CHAT.

    What to expect from your Express Reservation:

    • Simple and Easy Booking
    • Receive Email Confirmation within 1hour
    • Book any service from sedan, wheelchair van, private ambulance, medical RV or Air Ambulance with additional services if needed.
    • Immediate follow up if we need clarification
    • Plan assessment to ensure appropriate and lowest cost transportation
    • Call reminder(s) of your upcoming reservation
    • Make all your medical travel arrangements online
    • Convenience
    • Proud to receive 99.995% client satisfaction

    Book Your Express Reservation:

  • Sender Information:

  • Person being Transported:


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  • Pickup Information

  • Drop Off Information






  • Example: Patient Face Sheet
    Accepted file types: jpg, gif, png, pdf, jpeg, doc, docx, pages, xls, xlsx, sheets, bmp, Max. file size: 32 MB.

  • Note: Email confirmation will be sent after receiving and confirming your request for service.
    24 to 48-hour notice is appreciated. However, same day services must be scheduled by dialing (855) 263-7215.