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Services
Special event request Form

Inquiry

Special Event Coverage

Thank you for your interest in Special Event coverage by Falck. Please complete this form and we will send you a proposal.

Factors we take into account when preparing the proposal:

All requests must be made at least two weeks prior to the event
Event crowd size
Risk factors
EMS access to the venue (area traffic impedance)
EMS availability
Event impact on 911 operations.

We are eager to get in touch with you to discuss further details.

Request for proposal

Information about You

Event Coordinator

Title/Position

Email address*

Telephone number

Event information

Type of Event Sporting event
Community Event
Concert
Festival
Bike Race (Bike)
Running Race
Rally
Parade
Walk-a-Thon

Event Name

Event Date*

EMS start time

EMS end time

Location*

Location if not listed above

Event Address/Venue*

City*

Zip Code*

Maps of the course or venue are required unless the venue is a permanent sports or entertainment facility or park.

Specific location on the property for EMS vehicle(s) to stage, if applicable

Map upload

On-site information

On-site Contact

Telephone Number

Basic Life Support services feature two Emergency Technicians (EMTs) per unit and are fully equipped ambulances licensed and inspected by the Local Highway Patrol and EMS Agencies.
Advanced Life Support units complete state-of-the-art technology and equipment with trained paramedics allowing the treatment and transport of critical patients in a mobile hospital setting.