Event Request Form

First Name :
Last Name :
Agency/Association :
Contact Number:
E-Mail Address:
Date of Event:
Time of Event:
Length of Event :
Location of Event :
Type of Event :
Description of Event:

Event Disclaimer: Completion and submission of the above form does not guarantee acceptance of request. Each request is reviewed on an individual basis and acceptance does not guarantee aircraft availability.

MISSION STATEMENT
We positively impact the
quality of life of individuals
who utilize our air medical
services. Our core values
are: Safety, Excellence,
Compassion, Teamwork,
Cost Effectiveness,
Integrity and Community
Services

VISION STATEMENT
Air Care is a premier air
medical transport system
that is integrated with the
services of the sponsor
institutions and provides
value to the healthcare
community.

EMERGENCY CONTACT:
800-922-1234
Emergency Dispatch
(4 state toll free:
MI,IN,IL,OH)

269-337-2500
Emergency Dispatch

269-337-2509 (fax)
Dispatch/Crew Location

CONTACT INFO:
269-337-2505
Business Office

269-337-2506 (fax)
Business Office

888-575-9705
Patient Billing
Information (toll free)

West Michigan
Air Care
1535 Gull Road
Suite 100
Kalamazoo, MI
49048-1628

A cooperative program of Borgess Medical Center and Bronson Methodist Hospital.
© 2001-10 West Michigan Air Care, Inc. Privacy Policy.