AIR AMBULANCE BOOKING REQUEST

We’re here to assist you with scheduling non-emergency air ambulance transportation 24 hours a day, 7 days a week.

All air ambulance transports are based on availability; the more notice is provided, the better. Depending on the type of air ambulance transport required, the resources available on the specific location’s route, the mission’s time, duration, aircraft positioning, and level of complexity. Each transportation is booked on a first-come, first-served basis. We suggest between 48 to 120hrs in advance if possible. If your transport is needed in less than 48hrs., please call our dispatch office to provide your details and check for availability first.

Download Booking Form Or please fill in the following online form to schedule a transport:

Booking Request

Contact Information

Contact Name

Relation to the Patient

Company

Phone

Mobile or WhatApp

Fax

Other

Your Ref #

Transport Type

Type of transport (check what applies)

Include bed-to-bed transportation

Patient Info

Patient’s Name

Date of Birth

Transport Date

Height (in/cm)

Weight (Kg/Lb.)

Diagnostic & medical details

Passenger’s Info. (if approved)

Name

Relation

Date of Birth

Weight (Kg/Lb.)

Name

Relation

Date of Birth

Weight (Kg/Lb.)

Pick Up address & contacts

Location & Address

Type

Attending Doctor

Phone

Nursing Station or Department´s Name

Nursing Station or Department´s Phone

Floor & Room#

Facility Phone

Drop Off address & contacts

Location & Address

Type

Receiving Doctor

Phone

Nursing Station or Department´s Name

Nursing Station or Department´s Phone

Floor & Room#

Facility Phone

Payee Info

Payee Name

Phone

Billing address

Payment Type

Prepayment is required for all transports to be reserved. Payment can be made by bank wire, credit card, or credit card hold with bank wire within 3 days. We can also call you to obtain your credit card information if you prefer.

Special Instructions

On most standard air ambulance flights, one passenger and one patient at no more than 250 lbs. (113kg) per person are allowed on board. Each passenger may carry one 35 lb. (16 kg) standard carry-on-size luggage [with no more than 45 linear inches (22L x 14W x 9H in) or 113 linear centimeters (55L x 35W x 23H cm)] and one small personal item. Any excess luggage can be shipped to you at an extra cost.

Relevant to your air medical transport booking request, the following current documentation is recommended (if available):

For international transfers: Photos of passport(s) and visa(s), if applicable
Latest patient’s medical report or history and physical for air medical transport
Latest medical test results including COVID-19 for international transports
Memorandum of transport or latest discharge progress notes
Out of Hospital Do Not Resuscitate Order (if applicable only for terminal or hospice patients)
Any other relevant documentation

Drop files here or click to upload

Maximum file size: 10MB

Each trip is booked as per availability upon receiving a signed contract, payment, or credit card preauthorization. Upon receiving your complete schedule request, a flight coordinator specialist will check availability, check all details, and get back to you with a booking confirmation and a flight itinerary.

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AIR AMBULANCE BOOKING REQUEST

Contact Information

Transport Type

Patient Info

Passenger’s Info. (if approved)

Pick Up address & contacts

Drop Off address & contacts

Payee Info

Special Instructions

HEADQUARTERS

Headquarters