Our Medical Event Cover Booking and Risk Assessment Form is for guidance only, and event managers are advised to complete an independent assessment. The Risk assessment has been based on the industry recongnised formula, provided by the Health and Safety Executive – The Event Safety Guide, HMSO.

By using the form below you may obtain an estimated risk assessment total which will give an indication as to the level of cover required. Choose the options which best matches you event from each of the following sections.  Please note that submitting this form does NOT confirm or guarantee your booking.  Once we have received your submission, one of our operational team will be in touch with you to discuss your enquiry further.

Section 1 - Your Information

Please complete All the fields within this section as we will need the information to contact you if needed for further information and to send you a risk assessment review and quotation.

Your Name (required)

Your Organisation Name (required)

Your Email (required)

Landline Number (required)

Name of Event (required)

Address and Postcode of the Event (required)

Event Date and Times (required)
Insert Date(s):
Time: to

Section 2 - Risk Assessment

Please answer all of the questions below. You can select multiple answers by holding down the "CNTL" Key and clicking on all the answers within the section. If you are not sure or require further information regarding any of the questions below, please contact us.

Type of Event

Venue/Location of Event


Audience Profile

Past History

Expected Numbers

Expected Queuing

Time of Year

Proximity to definitive care (A&E)

Profile of definitive care

Additional Hazard's

Section 3 - Additional Information

Please let us know any other information which can support your risk assessment which can include other measures for example (for example if you are holding a fireworks display which a registered fireworks company has been contracted to carry out and will submit their own risk assessment, please let us know here.)

Section 4 - Please provide a brief summary of your event

Please provide a brief summary of your event for example "Our community event is aimed at families and has a range of stalls including food and crafts. There will be activities throughout the day in the main arena and music playing on a stage".

Section 5 -Addition provisions for your event

We would like to request an Ambulance at my event

We would like to request a Mobile Treatment Centre at my event

We would like to request a Medical Centre Gazebo at my event

We would like to request a Rapid Response Vehicle at my event

The event will require a 4x4 ambulance / response vehicle

We would like to request wound closure facility at the event

There is a room/building Ice Blue Medical can use as a treatment area/base

Section 6 - Billing Information

In this section, please let us know if the accounts contact information is the same as above or if we need to send it to a different person.

Is the details above the same for billing?

If "NO", Please complete the following:

Company Name:

Invoicing Address:

Reference number:

Accounts email address:

Accounts Contact Number:

Section 7 - Next steps

Using the information that you have supplied, Ice Blue Medical will e-mail you a quotation and review your assessment within the next five working days. We may need to contact you for further information. Please note that this form does NOT confirm a booking and does NOT confirm a contract to provide support at your event. Once we confirm your booking, Ice Blue Medical will require copies of the following documentation before we can provide any cover:

1 - Map of the Event
2 - Copy of your Event Risk Assessment
3 - Copy of your Event Action Plan