9-LINE MEDEVAC REQUEST FORM
LINE
EXPLANATION
1
PICK-UP LOCATION (COORDINATES)
2
CALL SIGN
3
CASUALTY BY PRECEDENCE
# ALPHA
Urgent (1 hr)
# BRAVO
Urgent surgery
# CHARLIE
Priority (4 hr)
# DELTA
Routine (24 hr)
# ECHO
Convenience
4
SPECIAL EQUIPMENT
ALPHA
None
BRAVO
Hoist
CHARLIE
Extraction equipment
DELTA #
5
6
Ventilator
CASUALTY BY TYPE
# LIMA
Litter
# APLHA
Ambulatory
SECURITY OF PICK-UP SITE
NOVEMBER
No enemy
PAPA
Possible enemy
ECHO
Enemy (caution)
X-RAY
Enemy (armed escort)
7
METHOD OF MARKING
ALPHA
Panels
BRAVO
Pyrotechnic signal
CHARLIE - COLOR
Smoke signal
DELTA
None
ECHO
Other
8
CASUALTY NATIONALITY/STATUS
ALPHA
US Military
BRAVO
US Civilian
CHARLIE
Non-US Military
DELTA
Non-US Civilian
ECHO
9
EPW
NBC CONTAMINATION
NOVEMBER
Nuclear
BRAVO
Biological
CHARLIE
Chemical
*IN PEACETIME
Terrain Description