BMRC Event Medical Questionnaire
Please respond to the following questions if you would like to have the Berkeley Medical Reserve Corps provide medical care at your event. You may always return to: to submit another response.
Email address *
Name of organization: *
Primary contact name: *
Primary contact phone: *
Primary contact email: *
Event name: *
Event date(s): *
Event time(s): *
Event location(s): *
What is the anticipated population size for the event? *
How many teams would you like to have on duty at this event? One team = two EMTs. *
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