West Metro Fire Protection District, CO

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Request for Special Event Paramedics

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Please fill out the following form to request Special Event Paramedic Services. When we have received your form, we will contact you within 3 business days. If you need immediate assistance, please call Jennifer Straub at 303-539-9541.

Name of Event*

Date of Event*

Event Address Location*

Start Time (Please enter the time you would like our paramedics to arrive)*

End Time (Please enter the time you would like to see our medics depart)*

Applicant First Name*

Applicant Last Name*

Phone Number*

Billing Address*

City*

State*

Zip*

Email Address*

Contact Person and cell phone number on event day if different than applicant listed above

Please Select type of Event you are hosting*

	Concert
	Community Gathering
	Fundraising Event
	Sporting Event

	H.S. or College Graduation
	Movie/Film
	Other

Please tell us more about your event:*

* indicates required fields.

West Metro Fire Rescue
433 S. Allison Pkwy.
Lakewood, CO 80226
Ph: (303) 989-4307

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