University Hospital Emergency Medical Services

Date of Presentation Requested:

Time of Presentation Requested:

Requesting Agency Address/Phone Number:

Contact Person Name/Rank/Position:

Contact Person Cell Phone #:

Contact Person E-mail Address:

Type of Request:
Helicopter Landing & Slide Presentation Slide Presentation Only Helicopter Only

Classroom Location (Facility Name / Address):

LZ Location (Name/Address) and Frequency(ies):

Comments/Requests/Special Instructions

Please check here if you would like CEUs for the lecture (2 CEUs approved by OEMS - please allow 60 days for the request to be processed)

The LZ must be 110 feet square, level, firm, and free of debris. No overhead obstructions such as power lines, large trees, cranes, etc can be present. The LZ must be physically secured by emergency apparatus and personnel.