Georgetown EMS Standby Request Form
Name of organization requesting EMS services?
What type of support would you like?
2 EMT First Responding (Must be at least 3 days In advance)
Ambulance Crew with 4 EMT's (Must be at least 7 days in advance)
Is the organization affiliated with Georgetown University?
Contact Email Address
Location of the event
Date of the event (mm/dd/yyyy)
Start and End time of the event (0000-2400)
Immediate questions or concerns?
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