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Life Flight Network continuously strives to provide the highest quality patient care and customer service. In order to identify methods to improve our service, we would appreciate your input by filling out this questionnaire. Thank you!
Please provide the
Unique Authentication Code
given by the transport team.
If you do not have a unique authentication code, please contact us, we'd be happy to provide one. email@example.com or call us at (503) 678-4364
Please enter the date of service
Please use the following format:
Example, January 3rd 2017 would be 01/03/2017
What type of request was this?
Transport from a scene
Transport between two facilities
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