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Bumbleance Transport Booking Request Form

Transport Booking Request Form from Bumbleance Website

Step 1 of 5 - Contact Information

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  • All fields must be completed - If a field is not relevant then please enter NONE or N/A

  • Child's Details

  • Applicant's Details

  • Medical Professional's Details

  • Parent's/Guardian's Details

    Note: A parent/guardian is required to travel with the child, along with any medical escort staff required, subject to the capacity of the vehicle. The ambulance attendant must travel in the back, which leaves 2 seats plus the stretcher. Wheelchair User patients or parents may use our adapted seat (where available) which may reduce vehicle capacity. Please note that BUMBLEance will contact you in relation to this Service.

  • Parent / Guardian 1

  • Parent / Guardian 2

  • Transport Information

  • DD slash MM slash YYYY
    Separate booking form required for different return date
  • :
    *** Please indicate the Appointment / Admission / Discharge time as advised by the Medical Facility. Times sometimes may require to be altered to ensure that we can facilitate the transport, we request all users to please consider that other service users may already be booked for our service on the same day. When booking appointments trips, please let us know well in advance, we like to maximise our logistics to help as many children and families as we can.
  • The Child's Mobility:
  • Please include units of measurement (kg, lbs, stone, etc.)
  • Please include units of measurement (feet, cm, etc.)
  • Please Give Details
  • Please Give Details

  • Referred By:

    [Complete as appropriate]
  • Please provide contact details for the referrer if possible.

  • Child's Medical Information

    I confirm the Child's medical details as follows:
  • Copies of DNR must be provided at time of booking

  • Data Protection

  • In accordance with the General Data Protection Regulation (GDPR) we are required to inform you that your details will be retained and held on file for administrative purposes by The Saoirse Foundation; owner and operator of BUMBLEance. Information on this form will be kept for a maximum of 5 years and may be shared with our operational partner(s) including state agencies. Please be assured that we will not pass this information on to any other organisation unless we have your prior consent. In order for us to provide this service we may need to contact you by email, phone, SMS or post.

    You can read our Privacy Statement here
  • Would you like to receive charity updates and event news from us?
  • You can help BUMBLEance by sharing, and allowing us to share, your trip experience with the public. We also like to take and receive photos, this support allows us to have the best vehicles on the road for your child and others. If you do not want to participate in supporting BUMBLEance in this way or want us to contact you please advise!
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About Us

Our Ambulances Our History Our Supporters

Contact Us

Registered Office: 2 James Street, Tralee, Co. Kerry, V92 T6PH

Office: 083 004 4444

BUMBLEance Bookings: 086 145 1470 or booking@bumbleance.com

Charity Information

CHY 19226
Registered Charity Number: 20075163
Company Number: 526496

The Governance Code

BUMBLEance is compliant with the Code of Practice for Good Governance of Community, Voluntary and Charitable Organisations in Ireland.

Learn more at: governancecode.ie

View our Privacy Policy

© 2023 BUMBLEance - The Children's Ambulance Service. The Saoirse Foundation. Other trademarks may be the property of their respective owners. | Privacy Policy |

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  • Home
  • About Us
    • About Us
      • Who We Are
    • Our Stories
    • Our Team
    • BUMBLEance Fleet
    • Angel Trips
    • Governance and Compliance
      • Board of Directors
  • High Spirits 2023
  • Corporate
    • Get your Company Involved
  • Get Involved
    • Register Your Fundraiser
    • Ways to Donate
      • Donate Now
      • Fuel Now!
      • Leave a Legacy
      • Donate your Birthday/Anniversary
      • Wedding Favours
      • Charity Tax Back on your Donation!
    • Campaigns & Events
      • High Spirits
      • Shocking Shirts
      • Brew For BUMBLEance
      • Challenges
    • BEE a Volunteer
      • Volunteer Sign Up Form
    • Shop
      • BUMBLEance Honey
  • Contact
  • Book a BUMBLEance
  • Donate
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