Event Requests

HealthNet Aeromedical Services takes pride in the communities we serve. Our aircraft and flight teams are available to attend community and school events.

If you would like to schedule an aircraft visit, please fill out the form below.

Requesting Agency *

Date of Event *

Month

Day

Year

Time of Event *

Hour

Minute

Address *

Street Address

Address Line 2

City

State / Province / Region

Zip / Postal Code

Country

Please describe the event *

Please describe the landing zone and any hazards that may be in the area *

Landing Zone Coordinates

Please list the fire department/EMS agency that will be on scene to assist with landing zone

Fire Department/EMS Agency Radio Channel

Event Contact Person *

Event Contact Phone Number *

Area Code

Phone Number

Event Contact Email

Will another air medical service provider be in attendance?

CAPTCHA

Please enter the word you see in the image