Event name
Event type/activities/brief description
Name of Event Manager
Event Manager telephone
Event Manager email address
Venue address
Dates of cover needed
From
To
Times of cover needed
Start
Finish
Number of staff required
Advanced First Aider
State Registered Paramedic
Ambulance Technician
Water/Height Rescue Technician
Doctor
Number of vehicles required
NE/Ambulance
4x4
Car
Emergency Ambulance
Estimated number of people/spectators
Estimated number of competitors
Maximum number of people expected on-site at any one time
Additional equipment required
Event invoice address/billing details
Details of any other medical cover attending
Event nature
To be completed in conjunction with your Risk Assessment, a copy of which is required.
Nature of event
Classical performance - score 2
Public exhibition - score 3
Pop/rock concert - score 5
Dance event - score 8
Agricultural/county show - score 2
Marine - score 3
Motorcycle display - score 3
Aviation - score 3
Motor sport - score 4
State occasions - score 2
VIP visits/summit - score 3
Music festival - score 3
Bonfire/pyrotechnic display - score 4
New Year celebrations - score 7
Risk level for demonstrations, marches and political events if applicable
Low risk of disorder - score 2
Medium risk of disorder - score 5
High risk of disorder - score 7
Opposing factions involved - score 9
Venue
Indoor - score 1
Stadium - score 2
Outdoor in confined location, e.g. park - score 2
Other outdoor, e.g. festival - score 3
Widespread public location in streets - score 4
Temporary outdoor structures - score 4
Includes overnight camping - score 5
Standing/seated
Seated - score 1
Mixed - score 2
Standing - score 3
Audience profile
Full mix including family groups - score 2
Full mix not including family groups - score 3
Predominately young adults - score 3
Predominately children and teenagers - score 4
Predominately elderly - score 4
Full mix, rival factions - score 5
Event intelligence
Numbers attending may vary throughout the duration of longer events. Therefore, resource requirements may need to be adjusted accordingly.
Past history
Good data, low casualty rate (less than 1%) - score -1
Good data, medium casualty rate (1-2%) - score 1
Good data, high casualty rate (more than 2%) - score 2
First event, no data - score 3
Expected numbers
<1,000 - score 1
<3,000 - score 2
<5,000 - score 8
<10,000 - score 12
<20,000 - score 16
<40,000 - score 24
<60,000 - score 28
<80,000 - score 34
<100,000 - score 42
<200,000 - score 50
<300,000 - score 58
Sample of additional considerations
Expected queuing
Less than 4 hours - score 1
More than 4 hours - score 2
More than 12 hours - score 3
Time of year
Spring - score 1
Summer - score 2
Autumn - score 1
Winter - score 2
Proximity to definitive care (nearest suitable A&E facility)
Less than 30 minutes by road - score 0
More than 30 minutes by road - score 2
Profile of definitive care
Choice of A&E departments - score 1
Large A&E department - score 2
Small A&E department - score 3
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