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EMS Standby Request

  1. CCEMS Logo - Est 2009 - PNG small
  2. EMS Standby Request Form
    Cole County Emergency Medical Services is honored you are interested in having us participate in your event. If you would like to have our EMS professionals provide medical coverage for your event. Please fill out the form in its entirety. Incomplete form may result in your request not being fulfilled.

    Please note if you require a dedicated EMS unit to remain on site for the entire event, meaning that the EMS unit cannot be in-service to handle emergency assignments, there is an hourly charge for this service.

    If you do not need a dedicated EMS unit at your event, please use the EMS Public Relations Request Form

  3. Event Contact Information
  4. I am aware that an hourly fee for a dedicated EMS unit will be charged to my organization.*
  5. My request is on behalf of a non-profit community organization?*
  6. Leave This Blank:

  7. This field is not part of the form submission.