ASU EHS Emergency Medical Services team request

Complete and submit this webform to request an EHS Emergency Medical Services team to attend your event.

Today's date

First name

Last name

Email

Phone number

Department

Event name

Does your event happen on more than one date?

Yes

No

Event start date

Event date

Event end date

Event location

Event start time

Event end time

Estimated number of attendees

Will other EMS agencies be present?

Yes

No

List the expected EMS agencies.

Use a comma to separate multiple agencies.

Will ASU Police be on site?

Yes

No

Will the event have any physical activities

Yes

No

Example: running or any sport activities

List the physical activities.

Use a comma to separate the activities.

What age group does the event target?

1-17

18-25

26-64

65+

Will alcoholic beverages be served at your event?

Yes

No

Provide a brief description of the event