Non-Contracted Standby Request

To request an ambulance for standby, please answer the
following questions and submit this form to City Ambulance

Rate: $160 Per Hour

For standard ambulance standby rate, request must be submitted by the 15th of the month prior to the event. Otherwise, a higher rate will apply.

Contact Information

To Whom Are the Charges Being Billed?

Billing Name	Billing Phone Number
Billing Mailing Address

What is/are the standby date(s)? Include starting time and ending times for each date.

What is the event location? Where should the crew stage during the event?

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