Medic Services for Motion Pictures and Special Events For more information visit www.codebluemedics.com Book a Medic, Lifeguard or Safety Pro Today Production Mangers or Event Coordinators, please complete [all fields] for booking below. First Name Last Name Direct Phone () - Email Company Name Billing Address Line 1 Billing Address Line 2 City State Zip Code Company Phone () - Fax () - Medic Type (EMT/Lifeguard/RN) Medic Requests/Requirements Job Name Job # Job P.O. # Working Dates First Day Call Time Approx. Wrap Time Job Supervisor 1 Contact Phone 1 () - Job Supervisor 2 Contact Phone 2 () - Additional Job Info Location Venue/Name Location Address Line 1 Location Address Line 2 Location City Location State Location Zip Directions/Parking Additional Location Info Thank you for sending your information, a representative will contact you shortly. For immediate assistance, please call 661-644-3422. Medic Services $300.00 © 2010 Code Blue Emergency Response, LLC All rights reserved. Unauthorized use prohibited.