Med Flight Fire and EMS Request Form

UW Health's Med Flight program is proud to be partners in emergency critical care and transport with fire and EMS programs and surrounding hospitals in Wisconsin, Illinois, Iowa, Michigan and Minnesota.


Med Flight staff provides training in setting up and securing a landing zone, preparing patients for transport, review of specific cases or types of patients, or topics of interest to your program.


If you are requesting on behalf of a Fire Service or EMS Program, complete this form. UW Med Flight staff will follow up within two weeks to confirm whether we can accommodate your request. At that point, we may need to gather additional information.

Date and Time Requested
Name of Fire Service or EMS Program
Requesting the following:
Landing Zone Education
EMS Education (add details below)
Attend Event (add details below)
Topics for EMS Education and/or Name of Event
Would you like the helicopter to attend?
Address of Landing Zone (please list any cross roads)
Agency Securing Landing Zone
Phone Number
DAY OF CONTACT INFORMATION (if different from above)
Phone Number
Details/Other Information
Follow Up
Date Verified
Map and Coordinates Printed
Added to the Calendar