Booking

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Booking

Make a Booking

Colbrow Medics is looking forward to providing the event first aid and medical services for your event. Please complete the form below with as much detail as possible, noting any fields with an asterix * is a required field and must be completed. Once you have submitted the form, a Colbrow representative will be in touch to confirm your booking and complete the booking process. If you require any assistance, please call 1300 550 123.

First Name
Surname
Email ID
Phone Number
EVENT ADDRESS :
Event Name
Event Date(s)
Times Required
Venue Name
Street Address
Street Address Line 2
City
State
Expected Number of Participants and Spectators
Anticipated Age Groups of Participants and Spectators
Number of Medics Required
Level of Medic(s) Required
EQUIPMENT REQUIRED - Subject to additional cost &/or availability :
Portable Oxygen Therapy Unit
Automated External Defibrillator
Colbrow Medics Cabana (small tent)
First Aid Station Identifier
Patient Monitoring Equipment
Event Vehicle
Is Free Parking Available?	yes	No
Where is the Arranged Meeting Point?
Is a First Aid Room Available?	yes	No
Is Other Shelter Supplied? (E.g. tent, umbrella, marquee)
Are Two Chairs Available?	yes	No
Is Running Water Available?	yes	No
Is Bottled Water Available?	yes	No
Will the Medic(s) be Catered for?	yes	No
Is There a Canteen?	yes	No
Is Alcohol to be Consumed?	yes	No
Will External Security be Present?	yes	No
Site Contact Name
Site Contact Phone Number
Extra Comments/Details
Return Client?	yes	No
If yes, do you agree to the Terms & Conditions stated within your previous Service Agreement?	yes	No
How did you hear about us?

Date Submitted