Patient Information

To qualify for a LifeLine Pilots’ mission a passenger must meet the following criteria:

  • have a medical or humanitarian need distant from home.
  • have a financial need for assistance.
  • be able to fly in a non-pressurized aircraft.
  • be able to board the aircraft with minimal assistance.
  • be able to sit upright in a standard aircraft seat.
  • be willing to sign a liability release form.
  • provide own transportation to and from the airport
  • submit a completed Mission Request Packet for consideration.

Please understand that this packet is to determine if you fulfill our criteria for a free flight. The Mission Request Packet consists of:

  • Passenger Information to be completed by the passenger, a support person or advocate for the passenger
  • Pre-Flight Information
  • Notice of Baggage Limits
  • General Flight Authorization
  • Liability Release and Indemnity Form
  • Physician’s Release Form to be filled out by your attending Physician
  • Notice Of Privacy Practices
  • Financial Verification Form to be completed by an independent professional third party (not a friend, relative, or neighbor)

Once all forms have been signed, returned, and approved, we can proceed with setting up a flight. We will do our best to help. If we are not in the office at the time of your call, please leave your name, location, and phone number with area code on our voicemail.

Mission coordination can be contacted at 1-800-822-7972 or by email at missions@lifelinepilots.org.