Vehicle Usage Request Form

Our department has three vehicles that may be used to transport supplies and personnel as necessary to carry out the functions of your initiative and for initiative-related travel. 

After a brief application and training process, Authorized Drivers will be permitted to request these vehicles for use. 

If your initiative provides clinical care that generates biowaste (including sharps), you must have an Authorized Driver for your events as these materials are required to be transported in a secure fashion in CEL vehicles.

THIS MUST BE COMPLETED 2 WEEKS IN ADVANCE OF YOUR EVENT

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Full Name *
E-Mail
Initiative / Organization / Department / Other *
Name(s) of all authorized drivers:

(only applicable if you are not the driver or not the only driver)
Which vehicle(s) would you like to use? *
Required
Would you or any of the other drivers like to test drive the vehicle before the event to get comfortable? *
Destination Address *
Date of desired pick-up *
MM
/
DD
/
YYYY
Time of desired pick-up *
Time
:
Date of planned return *
MM
/
DD
/
YYYY
Time  of planned return *
Time
:
Questions, Comments, or Concerns
Submit
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