Organization Request Form

In order to create your organization page, enrollment form, and dashboard, we need a few details from you. Please complete the following form. We create new accounts Monday-Friday within 24-48 hours of your submission. Friday-Sunday submissions will be reviewed on Monday.

Provide full name of organization
In what US state or Canadian province are you located?
For example, if you are an MCA, what is your Region? If you are an agency, is your medical control authority?
Email us a 250 x 250 pixel png file logo or provide a link to it here, and we'll resize it.
Parent organizations are usually the Group Leader and another administrator or a small team that would have access to each affiliated agency, agency personnel, and reports.
For example, Acme Township Fire Department, 18; South Boardman Fire Department, 12.
A custom membership plan for your organization will be created based on the number of personnel.
We'll email or call if we have questions. Thank you!
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