SERT Event Medical Coverage Request Form

If you would like a designated SERT team at your event please complete the following form. We ask that you provide 4 weeks notice so that we have sufficient time to schedule responders and prepare for your event. After review by our Response Coordinator we will contact you with our pricing information and to confirm the details. If you have any questions please email our Response Coordinator directly.

**Please note, we are haveing difficulty with our form on our website. Please use this linked Microsoft Form to submit event coverage requests.**

    Event Organizer Name:

    Telephone Number:

    Email Address:

    Event Name:

    Type of Event:

    Event Website:

    Is this event in support of a charity?

    If you answered "yes" to the above question, please provide the charity's registration number. If you do not know this number please visit the CRA website to find out.

    Event Date:

    Event Start Time:

    Event End Time:

    Event Location:

    Is the event indoors, outdoors or both:

    Expected Attendance:

    Will food be provided for our volunteers?

    Will we have access to power at your event

    Is there any additional information we should be aware of?

    Please upload any documents that will help us provide medical coverage at your event (ie. maps, schedules, etc).

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