Events Ireland: Quote Request

Quotation Request Form

Please complete this form with as much detail as possible to receive a no-obligation quote. We're delighted to be considered for your event's medical cover needs.

Thank you for choosing Codeblue! Should you have any queries before receiving your quote, feel free to reach out to us at events@codeblue.ie or contact Aaron Cullen (Operations Manager) directly by phone or whatsapp on 0830943404.
Have we provided medical cover for your organisation before?
Name

First NameLast Name
Email
example@example.com

Organisation / Company Details
Company / Organisation Name
Organisation Type
Company Registration Number (CRN)
PPSN
Tax Reference Number
Registered Charity Number (RCN)
Billing Address

Address Line 1

Address Line 2

CityState / Province

EircodeCountry
Contact Person Details
Contact Name

First NameLast Name
Contact Phone Number

Area CodePhone Number
Contact E-mail
example@example.com
Would you like to add another contact person who will also receive the quotation by email?
Contact #2 Name

First NameLast Name
Contact #2 E-mail
example@example.com
Would you like to add a separate finance contact to receive invoices?
Invoice E-mail
example@example.com
Event Name & Location
Event Name
Event Description
Event Address

Address Line 1

Address Line 2

CityState / Province

EircodeCountry
Event Location Directions / Location Notes (optional)
Medical Cover Details
Do you know the exact times for the medical cover?
Medical Cover Start Date & Time

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
Hour MinutesAM/PM Option
Medical Cover End Date & Time

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
Hour MinutesAM/PM Option
Medical Cover Date

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
How many hours of medical cover are required?
Would you like to add another dates for the same event?
Date #2: Medical Cover Start Date & Time

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
Hour MinutesAM/PM Option
Date #2: Medical Cover End Date & Time

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
Hour MinutesAM/PM Option
Date #2: Medical Cover Date

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
Date #2: How many hours of medical cover are required?
Date #3: Medical Cover Start Date & Time

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
Hour MinutesAM/PM Option
Date #3: Medical Cover End Date & Time

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
Hour MinutesAM/PM Option
Date #3: Medical Cover Date

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
Date #3: How many hours of medical cover are required?
Date #4: Medical Cover Start Date & Time

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
Hour MinutesAM/PM Option
Date #4: Medical Cover End Date & Time

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
Hour MinutesAM/PM Option
Date #4: Medical Cover Date

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
Date #4: How many hours of medical cover are required?
Date #5: Medical Cover Start Date & Time

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
Hour MinutesAM/PM Option
Date #5: Medical Cover End Date & Time

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
Hour MinutesAM/PM Option
Date #5: Medical Cover Date

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
Date #5: How many hours of medical cover are required?
Specific Activities Taking Place
Event Website
Expected Number of People Involved (Please include participants, spectators or any other staff/volunteers on site)
How will they be accommodated (Select all that apply)

Other
Demographic - Who is the event aimed at (Select all that apply)

Other
Are there other organisation's involved in the provision of Medical Services to this event?
Event Details
Who do our team report to on the day (Point of contact)

First NameLast Name
Point of contact phone number

Area CodePhone Number
Is there a facility available for treating casualties in private?
Is there access to tap drinking water?
Is there free parking available onsite for our team?
Please detail the medical resources you feel are required for your event
e.g. Number of Ambulances, First Aid Points, Response Vehicles, Paramedics, Technicians, First Aiders etc.. and estimate how many. (Details of what your last Medical Team supplied would be a good starting point).
Please detail any further supporting information
This might include previous injury/incident data, details of any additional resources that could be made available to our team etc.
Upload any supporting documentation

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Discount Eligibility

At Codeblue, we offer discounted rates to clients who choose us for multiple events. Discounts are based on total invoicing and volume of work.
Do you require medical cover for multiple events throughout the year?
Approximately how much do you typically spend on medical cover per year across all providers?
Would you like a discounted quote based on your total annual medical cover spend and, if satisfied, commit to using Codeblue for all cover within that value?
Terms & Agreement
By submitting this form, I request a quotation for Codeblue’s services. I understand that completing this form does not confirm a booking.

I acknowledge that full terms and conditions will be provided with the quotation. I agree to provide all relevant documentation, including risk assessments, site plans, and emergency escalation plans, as required.
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