EMS/Ambulance Stand-By Request - Monroe County Hospital

Requests for EMS/Ambulance Stand-By services must be submitted no later than two (2) months prior to the scheduled event date to ensure adequate staffing and availability. Requests received after this timeframe may be accommodated based on operational capacity but cannot be guaranteed.

At the time of request, the requesting party must specify whether EMS personnel are expected to be on-site for the duration of the event or whether a stand-by/on-call arrangement is preferred, in which EMS may arrive, depart, or reposition as needed based on event activity and risk level.

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Requestor Information

Name of Requestor*

Organization / Event Host*

Phone Number*

Email Address*

Address*

Street Address Address Line 2 City State ZIP Code

Event Information

Event Name*

Event Type (sporting event, concert, festival, school event, private event, etc.)*

Event Date(s)*

Start Time*

End Time*

Event Location (full address)*

Street Address Address Line 2 City State ZIP Code

Expected Attendance / Crowd Size*

EMS Coverage Details

Staffing Preference:*

EMS personnel on-site for the full duration of the event

Stand-by / on-call arrangement (crew may leave the site due to transfers or 911 calls)

Additional Notes / Special Requests