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Event Standby Request

Willamette EMS can be requested to be on standby for emergency medical services at your event on or off-campus. Just fill out the form below and we will get back to you as soon as we can!

Please submit this request at least 7 days before your event. 

WEMS is only available for standby services during the normal school year; we are not available during breaks.

Personal Information
Your Name is required.
Your Phone Number is required.
Event Information
Event Name is required.
Event Date is required.

mm-dd-yyyy

Event Times is required.

Please provide the start and end times of your event.

Event Sponsor is required.

Group, organization or department putting on the event.

Where will the event be? is required.
Event Location is required.

Provide details of location, such as address, building, room number(s), etc.

Event Description is required.
Terms

By signing and submitting this request, you agree to the following terms:

  1. I acknowledge that this request, regardless of how early it is submitted, does not guarantee that WEMS will be able to provide standby service for my event.
  2. I acknowledge that WEMS will only serve as standby first aid and emergency medical service to my event. I will not task WEMS members with other duties outside of providing first aid and medical services.
  3. I understand that WEMS volunteers are not legally able to diagnose potentially injured attendees of my event, nor is WEMS able to formally clear attendees to resume event activities. 
  4. WEMS members will operate under the protocols signed and approved by the Willamette EMS medical director.
  5. I understand that WEMS is only obligated to provide standby services within the provided event times.
  6. It is unlikely that WEMS will have available responders over summer, thanksgiving, Christmas, spring break, or federal holidays.
  7. I understand that WEMS may only provide standby services for events within the state of Oregon.
Electronic Signature is required.

Type your full name as to signify that you have read and agree to the above disclaimers.



Willamette University

Willamette Emergency Medical Services

Salem Campus

Phone
503-370-6911
Email
wemsdirector@willamette.edu

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