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Medical Standby Request Form

  1. Unit(s) and personnel are provided on a "for hire" basis. Requests must be made at least 2 weeks in advance of the event. 1 crew is considered to be 2 medics and 1 emergency vehicle. Its important for you to know that any emergency resulting in a transport will mean that during the time the crew and vehicle are off site PCFD will NOT provide another standby unit.
    Any requests for emergency response during that time will be dispatched through regular procedure until at which time the "for hire" unit is released back into service.
    Services resulting in transport will be billed to the patient.

  2. Rates: $60.00 per hour
    Includes 2 medics at $30 each* Billing will include a base fee of $50 to cover the cost of time involved in preparation and clean up.

    *These charges are contractual and not subject to negotiation.

  3. Event Information

  4. Billing Information

  5. Leave This Blank: