9 Line MEDEVAC Request

  Line 1. Location of the pick-up site.

GPS coordinates, description

Line 2. Radio frequency, call sign, and suffix.

Line 3. Number of patients by precedence:

• A – Urgent
• B – Urgent Surgical
• C – Priority
• D – Routine
• E – Convenience

Line 4. Special equipment required:

• A – None
• B – Hoist
• C – Extraction equipment
• D – Ventilator

Line 5. Number of patients:

• A – Litter
• B – Ambulatory

Line 6. Security at pick-up site: (In peacetime – number and types of wounds, injuries, and illnesses)

• N – No enemy troops in area
• P – Possible enemy troops in area (approach with caution)
• E – Enemy troops in area (approach with caution)
• X – Enemy troops in area (armed escort required)

Line 7. Method of marking pick-up site:

• A – Panels
• B – Pyrotechnic signal
• C – Smoke signal
• D – None
• E – Other

Line 8. Patient nationality and status:

• A – US Military
• B – US Civilian
• C – Non-US Military
• D – Non-US Civilian
• E – EPW

Line 9. NBC Contamination: (In peacetime – terrain description/ possible hazards of pick-up site)

• N – Nuclear
• B – Biological
• C – Chemical