Iowa Health - Des Moines is now UnityPoint Health - Des Moines

Life Flight Event Visit Request Form

Before submitting this form, please make sure you know the landing zone GPS coordinates (latitude and longitude - i.e., 43 36 / 090 41). All requests are subject to management approval and aircraft availability on the day of the event.

Date of Event(4 week notice preferred)Arrival TimeDurationRequesting AgencyContact NameContact E-MailContact Cell PhoneAlternate PhoneContact and Phone Number for Day of the EventType of RequestDetail (explain)Group Making RequestExpected AttendanceLocation/AddressGPS CoordinatesLanding Zone SurfaceOther (explain)Obstacles (check all that apply)






Landing Zone Obstacle DetailsAgency Providing LZ Security?Radio FrequencyTone Codes?Radio Call Sign