Standby request form

Please fill out the form below to request a medical standby.
Required fields are marked with a *.

Questions? Contact info@cmuems.org.

Contact

Event

Standby

Standby times*: Start End Please include at least a half hour before and after event.
Special Situations: Please describe any special situations we may need to be aware of
First aid station location(s): If you would a first aid station, please list the location and any other details
Have you requested the following?
1. Ambulance standby: Yes No
2. Campus Police: Yes No
3. Pittsburgh Police: Yes No

Payment

In case of emergency:

412-268-2323

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