Requesting event medical services

Event medical services

Harlow Combined are able to provide medical services for your event, please complete and submit this online form, one of our volunteers will then contact you withing 7 days to discuss your requirements.

 
Organisation Details
Organisation Name
Registered Charity No.
Event Details
Date
Start
End
Event Name
Event Location
Event Postcode
Event comments
Cover Required
Ambulance and 2 Ambulance Crew
Mobile First Aid unit and 2 First Aiders
Static First Aid unit and 2 First Aiders
Additional First Aiders Required
Paramedic
Will Food / Drink be provided
Main Contact Details
Name
Title
Address
Post Code
Email
Main Phone Number
Phone Number 2
Phone Number 3
Invoice Contact Details
Use Main Contact
Name
Title
Address
Post Code
Email
Main Phone Number
Phone Number 2
Phone Number 3

Please Note : Submission of this form does not constitute a formal agreement to undertake provision of First Aid or Ambulance services for the listed event
 
 
 
 
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