Apply for support from TASC

First Name*

Last Name*

Phone number*

Email address*

I am:
Currently working in an NHS ambulance serviceCurrently working in an independent ambulance serviceRetired and used to work in an NHS ambulance servicea Paramedic Science studentThe family member of someone who is or has worked for an ambulance servicea UK ambulance service volunteer

Please provide details of your current employment status, including your job title, employer and length of service.*

If you're currently off work or on reduced/alternative duties due to illness or injury, please provide detail below.

I live in*:
a property I owna property I am privately rentinga housing association or a local authority propertysheltered accommodationa residential or nursing homeno fixed abode

Please provide details of all your current dependents. This includes all children under the age of 18 and anyone you have a caring responsibility for.*

Finally, please provide as much detail about your current situation as you can and what support you're looking for.*

  I confirm I have read TASC’s eligibility criteria and confirm that I am eligible to receive support from TASC

First Name*

Last Name*

County*

Telephone number

Mobile number

Email address*

I am:
Currently working in an NHS ambulance serviceCurrently working in an independent ambulance serviceRetired and used to work in an NHS ambulance serviceStudentThe family member of someone who is or has worked for an ambulance serviceUK ambulance service volunteer

If you are a currently serving or retired ambulance staff member, have you been in post for at least 12 months?
yesno

Write us a message

  I confirm I have read TASC’s eligibility criteria and confirm that I am eligible to receive support from TASC