Air Ambulance Providers Form

1 Company info

2 Air ambulance

3 Insurance

4 Staff & Equipment

Insurance
Insurance policies*
Please attach copies of your insurance policies and list the geographies where you are covered
Drop files here or
Staff (pilots,medical,etc.)
Do you have employment/consultant contracts with them?*
- Yes
- No
Are they covered by the insurance policies?*
- Yes
- No
If not, who are their employers? Under what terms do they fly on your aircraft? Who provides the insurance coverage for the categories listed above?
1) Flight nurse practices are covered by the policies held by?
2) Flight doctor practices with the mission outlines
3) Pilots and technical operational crews practices are covered by the policies held by?

Type	How many	Range	Stretcher capacity	Stretcher out of aircraft

Air ambulance questionnaire