Star Medical Services Limited

Purple Guide Risk Assessment

Quote Request from

Please complete the questions on this form in order for us to risk assess your event and ensure you are getting the correct cover

Name

Phone

Name of Event

Address of Event

Nature of Event

Start date of event

Start time of event

Finish time of event

Finish date of event

Type of Venue

Standing or Seating

Audience Profile

Past Casualty Figures

Expected Numbers

Expected Queueing

Time Of Year

Nearest A&E

Type of A&E

Additional Hazard

Please provide details of the facilities provided

Please attach your event plan

Please attach site Map

Please attach copies of risk assessments

Any general comments