Medical Standby Request - Perry Township Fire Department

Perry Township Fire Department
Medical Standby Request

To apply for medical standby support for an event, please fill out the form below.

Please not that any out of district events are dependent on that department’s coverage area approval and board approval.

Contact Person

Contact Email

Contact Phone

Preferred Form of Contact

Name of Event

Location of Event

Date of Event

Description of Event

Type of Need from Perry

How long are the services needed?

How many people are needed?

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