Request For EMS Standby Service
Hopewell Emergency Crew, Inc.
 
 
The Hopewell Emergency Crew can perform an EMS Standby at your next event.  During a standby we will provide your event with an on site ambulance staffed by either Basic Life Support or Advanced Life Support, whichever you request, that can provide treatment and transport should anyone become suddenly ill or get injured.  The unit assigned to your event will be present upon commencement of the event and will remain on site until the end or a time specified by you.  We can even perform health screenings, provide health related literature, answer questions, and much more.  If you are interested in our standby service, please fill out the short form below and you will contacted by our Personnel Division to complete your request.
 
  
 
 
Date of Request**:
Business or Organization Name:
Contact Name**:
Email Address**:
Mailing Address**:
Mailing Address 2:
City**:
State **:
Zip Code:
Contact Phone Num.**:
Date of Event**:
Event Start Time**:
Event End Time**:
Type of Event:
Where Will The Event Be Held?:
 
(** Required Fields)

 
 
 
 
 
 
 
 
 
 
 
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