Request a Flight

Fill out the forms below to request a flight.

All information must be provided.

We require all patients to complete each of the following forms in order to qualify for assistance.  Paperwork must be received within the required timeframe, at least 10 business days prior to the departure date.

We also require an original picture of the patient and a brief story for our files.

View Sample Story

Click Links to Download

• Flight Request Form
• Patient Privacy Policy
• Waiver of Liability
• Patient Criteria
• Doctor Certification
• Income Certification
• Administrative Fee
• Donor Privacy Policy