Special Event Requests

Thank you for your interest in having Tri-State Ambulance at your next event. Please provide the necessary information by completing the form below and we will contact you to discuss scheduling and other details.

Which company are you requesting for your special event?

Contact Information

This section contains the contact information necessary to schedule an event.
First name of the requestor
The name of the company or organization requesting our services.
The e-mail address to contact to confirm receipt and request further information.
The phone number to contact to confirm receipt and request further information.
Last name of the requestor
Please select the type of organization requesting our services.
This is the contact address for the individual, company, or organization requesting our services.

Event Details

This section containts the details of the specific event request.
Please select the type of service you would like TSA to provide. A dedicated ambulance means it will not be available to take other calls. Non-dedicated ambulance will be present unless a call comes in which they will respond to.
What is an estimate on the projected attendance at this event?
On what date does the event start?
What time would you like Tri-State Ambulance on site?
If the event will occur over multiple days, please specify the number.
Time Tri-State Ambulance will be free to depart the event.
What is the name of your event?
Please describe the event.
What is the address of the event?
Please include any additional specific information you feel may be necessary to for TSA to successfully staff your event.