Denver Health Paramedic Division - Event Request Form
Name:
First Name
Last Name
Date of Event:
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Time of Event:
Hour Minutes
AM
PM
AM/PM Option
Email:
example@example.com
Phone Number:
Please enter a valid phone number.
Format: (000) 000-0000.
Request for Denver Health Paramedic Participation: (Select all that apply):
Medical Coverage: Dedicated resources to respond to medical emergencies during your event. *Fees may apply
Community Outreach: A Denver Health Paramedic/EMT to provide education and answer questions during your event
Parade Participation: Vehicles to participate in a parade
Honor Guard: A specialized unit with-in the Denver Health Paramedic Division which provides Honor Guard services including, but not limited to, opening/closing ceremonies, and presentation of flags at events.
I'm not sure
Submit
Should be Empty: