Form Center

By signing in or creating an account, some fields will auto-populate with your information.

EMS Public Relations Request

  1. CCEMS Logo - Est 2009 - PNG small
  2. EMS Public Relations Request
    Cole County Emergency Medical Services is honored you are interested in having us participate in your event. If you would like to have our EMS professionals attend and bring an ambulance, please fill out the form in its entirety. Incomplete form may result in your request not being fulfilled.

    For all Public Relations Events, our EMS Professionals remain in-service and are available for emergency assignments.

    If your event requires a dedicated unit that remains on site and is not subject to being called away for an emergency, then please use the EMS Standby Request Form

  3. Event Contact Information
  4. I understand that if a EMS unit is able to attend, they are in-service and will be available for an emergency assignment, and they may leave at a moments notice.*
  5. Leave This Blank:

  6. This field is not part of the form submission.