MedEvac PR or Training Request Form

Complete the form below to request Fire/Rescue safety training or other training and education from Aspirus MedEvac.

Please note: Submitting a request Does NOT Guarantee acceptance or that it will be scheduled. Also, events that do get scheduled may be cancelled due to urgent patient needs, weather, vehicle/helicopter maintenance, or the availability of staff or equipment.

After this form is received, an Aspirus MedEvac representative will contact you within 3-5 business days.

Request Form

* indicates required field

Name of your organization: *

• Your first name: *
• Your last name: *
• Your daytime phone number: *
• Email: *

Type of request: * -- select -- Outreach Education Request PR Request Aircraft PR Request Ground Unit Other

Describe topic or details of your request: *

• Where are you located? * -- select -- Michigan (UP) Wisconsin
• City: *

Where would event be held? *

Proposed date(s) and time(s): *

Number expected to attend: *

Any additional event information or details?