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Forms

Required fields are marked with asterisks (*)

Public Relations Request Form

Essex-Windsor Emergency Medical Services makes every effort to attend all public relations requests, however, attendance is often dependent on the availability of staff and ambulances.

It is recommended that you provide at least 4 weeks advance notice for your event.

If you would like to request Essex-Windsor EMS attend your special event, please fill out this form and an Essex-Windsor EMS representative will contact you within 72 hours.

Please note, this is for public relations only and is not a request for medical coverage.  if you would like to request dedicated medical coverage for your event, please use our "Medical Coverage Request" form.

Event Information

Have we attended your event before?
 
Event Type:
 
What are you requesting?
 
Event Style:
 
Number of Participants:
 
This event is:
 

Contact Information

This information will be used to contact you about your event. Please be sure to accurately complete all fields.



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