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9 Line MEDEVAC Request

 

Line 1. Location of the pick-up site.

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:
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)
* In peacetime – number and types of wounds, injuries, and illnesses

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:
N – Nuclear
B – Biological
C – Chemical
* In peacetime – terrain description of pick-up site