Communication Request Form - Emergency Medical Services Charlotte NC

Name

First

Last

Phone

Approval *

I have Manager or Deputy Director Approval for this Communication

EMERGENCY COMMUNICATIONS

Please note: all emergency communications must have PR Supervisor approval prior to distribution.

Is this an EMERGENCY communication? Check YES if your communication references an immediate threat to person or property only. *

COMMUNICATIONS INFO

Which eGroups should this communication go to?

All Medic Employees
Operations (Field/CMED including Ops Sups, Managers & all Directors)
Field Employees (Field including Field Ops Sups, Managers & all Directors)
CMED (CMED including CMED Supervisors & CMED Manager)
Admin Employees
Directors Team
Management Team
Lead Team (All Supervisors, Managers & Directors)

Subject *

Distribution Date / Time *

Date

Time

Do you want to give a certain group(s) 24-hour notice?

If yes, who does the 24-hour notice go to? (Check all that apply)

Would you like your message distributed on the following optional distribution mediums:

Dispatch
MedTV
Hot Sheets (PR Supervisor Approval Needed)
CAD Page (PR Supervisor Approval Needed)
Logistics' Window Flyer (PR Supervisor Approval Needed)
Video Content (PR Supervisor Approval Needed)
I will Yammer

*Remember that we encourage all members of the leadership to post their own communications on Yammer (in your own voice). Please post after formal communications are sent by PR.

If applicable, what is your CAD page message?

What is your email message? *

Upload additional documents / images (*If a promotion or new hire announcement, please include a photo or give PR ample time to take one of the employee)

Click or drag files to this area to upload. You can upload up to 5 files.

Each file size must be 5MBs or smaller.

Do you have any special requests or directions for us?

Point of Contact

The person filling out this form is the default contact UNLESS this section is filled out.

How should employees contact someone if they have questions?

Email
Phone