MEDICAL EVENT COVER BOOKING FORM | Elite Care Medical 24

Our Medical Event Cover Booking and Risk Assessment Form is for guidance only, and event managers are advised to complete an independent assessment. The Risk assessment has been based on the industry recongnised formula, provided by the Health and Safety Executive – The Event Safety Guide, HMSO.

We understand that events are often planned and organised outside of normal working hours:

You can call our management, operational and clinical advice teams at any time of the day.
We are a national company so are able to provide you with a competitive no obligation quote for your event.
From First Responders to Health Care Professionals – Elite Care Medical 24 provide different levels of cover tailored to suit your events medical and welfare requirements.
The correct level of cover if of the utmost importance.
We will work in partnership with you to deliver cost-effective quality care and a professional service.

By using the form below you may obtain an estimated risk assessment total which will give an indication as to the level of cover required. Choose the options which best matches your event from each of the following sections. Please note that submitting this form does NOT confirm or guarantee your booking. Once we have received your submission, one of our operational team will be in touch with you to discuss your enquiry further.

Section 1 – Your Information

Please complete all fields within this section as we will need to contact you for further information and to send you a risk assessment review and quotation.

Your Name *

Email Address *

Your Organisation Name *

Name of Event *

Address and Postcode of the Event *

Contact Telephone Number *

To Include Overnight Cover *YesNo

To Include Overnight Camping? *YesNo

Event Date *

How many days is your event on for? *How many days will you require medical and welfare cover?

Event Start Time *

Hours

Minutes

Event End Time *

Hours

Minutes

Section 2 – Risk Assessment

Please answer all of the questions below. If you are not sure or require further information regarding any of the questions below, please contact us.

NATURE OF EVENT *

EVENT VENUE / LOCATION *

STANDING / SEATED *

AUDIENCE PROFILE *

PAST HISTORY *

EXPECTED NUMBERS

EXPECTED QUEUING *

TIME OF YEAR *

PROXIMITY TO DEFINITIVE CARE (A&E) *

PROFILE OF A&E *

ADDITIONAL HAZARDS *

ADDITIONAL ON-SITE FACILITIES *

Your Event Risk Score:

Section 3 – Additional Information

Please let us know any information which can support your risk assessment. This can include other measures for example – if you are holding a fireworks display whereby a registered fireworks company has been contracted to carry out and submit their own risk assessment.

Do you have public liability insurance? *

Is there vehicle access to the event? *

Do you have on site parking? *

Type of Terrain event is held on: *

Will there be any other first aid trained personnel on site? *

Have you carried out an event risk assessment? *

What form of communication between organisers will be used during the event? *VerbalRadioMobile PhoneWhatsApp Group Chat

Section 4 – Please provide a brief summary of your event

Please provide a brief summary of your event, for example, "Our community event is aimed at families and has a range of stalls including food and crafts. There will be activities throughout the day in the main arena and music playing on a stage". *

Section 5 -Additional provisions for your event

We would like to request an Ambulance *

We would like to request a Mobile Treatment Centre *

The event will require a 4×4 ambulance / response vehicle *

There is a room/building the medical team can use as a treatment area/base *

We would like to request a Medical Centre Gazebo *

We would like to request a Rapid Response Vehicle *

Section 6 – Accounts Information

In this section, please let us know if the accounts contact information is the same as above or if we need to send it to a different person.

Are the details above the same for your accounts team? *If “NO”, Please complete the following:

Accounts Name

Accounts Phone Number

Accounts Email Address

Accounts Reference number:

Using the information that you have supplied, Elite Care Medical 24 will e-mail you a quotation and review your assessment within the next 48 hours. We may need to contact you for further information. Please note that this form does NOT confirm a booking and does NOT confirm a contract to provide support at your event.

Once we confirm your booking, Elite Care Medical 24 will require copies of the following documentation before we can provide any cover:

1 – Map of the Event
2 – Copy of your Event Risk Assessment

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