Aeromedical Transfer Enquiry Form

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Aeromedical transfer enquiry form

RFDS Victoria provides low, medium and high acuity aeromedical transfers, repatriations and retrievals across Victoria, connecting with cities and towns around Australia.

Please complete the form below for further information or a quote for using RFDS Victoria's aeromedical patient transport and a member of the flight operations team will be in contact as soon as possible.

If your enquiry is urgent please contact the RFDS Essendon Flight Operations Centre on 0419 260 182 or you can email flight.operations@rfdsvic.com.au

* required fields

Patient Name

Please enter the full name of the patient.

Patient date of birth

Origin Location

Please enter the city, town or suburb where the patient will be collected from. If the patient is in a medical facility please include the name of the facility.

Destination Location

Please enter the city, town or suburb where the patient will be transferred to. If the patient is being transferred to a medical facility please include the name of the facility.

Is the patient currently an inpatient at a hospital or an aged care facility?

Yes No

How is the cost of this transport funded?

Hospital to pay Patient to pay Third party (eg TAC/insurance/WorkCover) Undetermined Other

Enquirer name

Please enter your full name if different to the patient.

Relationship to patient

Organisation

If you are filling the form out on behalf of a hospital, facility or organisation.

Contact number

Contact email

* required fields