EMS Standby Request Form

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This form will provide us with information about your event. Events will be covered on a first come, first serve basis as staffing levels and funding allow. Please note that Emergency Calls will still be priority and depending on the event EMS coverage may have to leave to cover other calls. Please call our station at 831-6900 or e-mail at ruems@radford.edu with any further questions.

Event Name *

Event Date(s) *

Event Time Period *

Location *

Primary Contact Name *

Organization *

Contact Email *

Estimated Attendance

How many people do you expect?

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