Rollover Simulator Request Form

Thank you for your interest in the Rollover Simulator.  Before you request use of the simulator, please carefully read through the minimum criteria needed to request and transport the display.  


Event Information
Event Name *
Location of Event *
Address of Event *
Pick-up Date * (MM/DD/YYYY)
Drop-off Date * (MM/DD/YYYY)
Potential number of people reached *
Type of audience *
Personal Information
Name of requesting law enforcement agency *
Name of trained transport and display personnel *
Email Address *
Phone Number *
Minimum Criteria
Are minimum criteria met? * Yes     No    
Have you looked over the Rollover Simulator instructions and checklist? * Yes     No    
Once submitted, your request will be sent to the advisory board for approval.  Kristi will get back to you in approximately 1 - 2 weeks to discuss approval and any concerns.  

  

Received a bill from us?

Paying your ambulance bill online is fast and easy!

Or call our billing department at 701-234-1222 from 8:00 AM - 4:30 PM, Monday - Friday. 

Tours

F-M Ambulance Service recognizes the benefits of showing the general public what emergency services is about. One way to promote EMS is to provide tours at no cost to the public when ever we are able to. If you are interested in setting up a tour with one of our ALS ambulance units, contact us by email here: 

Check us out on:

F-M Ambulance Service on Facebook F-M Ambulance Service on Twitter F-M Ambulance Service on You Tube

 

 

Need a car seat or bike helmet checked?

Click here for info on the Safety Shoppe!