Wings of Mercy
If at any time you have questions contact the office at:
 
Phone: (616) 396-1077
Toll Free: 888-786-3729
 
By email at:
 
 
When the forms are all completed please fax them to the office at:
 
Fax: (616) 396-0650
 
Or mail them to:
 
Wings of Mercy
10720 Adams Street
Holland, MI  49423
 
Patients
 
APPLICATIONS WILL NOT BE PROCESSED UNTIL ALL DOCUMENTS ARE RECEIVED


Must be Filled Out and Returned
 
 
Reference Person
    - Page 1
    - Page 2
 
 
 
 
For Patient Information Only (Does Not Need to be Returned)
 
 
 
 

Pilots
 
 
IMPORTANT: Applicants are also required to forward photocopies of License, Medical and Biennial or Competency Check.  In order to make sure we recieve a legible copy please see our Instruction Form.
 
APPLICATIONS WILL NOT BE PROCESSED UNTIL ALL DOCUMENTS ARE RECEIVED
 
 
Aircraft Owners
APPLICATIONS WILL NOT BE PROCESSED UNTIL ALL DOCUMENTS ARE RECEIVED

 
©2010 Wings of Mercy West Michigan, Inc.