THOMAS A. TWOMEV. IR 

•JTEPHrNi B LATHAM 

JOHN F SHEA. Ill 

CHRISTOI'HER D. KEUE> 

hlVICl M DLIPJNO 

JAV r tiLIARTARAROt 

PETER M MOI T 

IANICE L. J;NEAD 

ANNE MARI E HOODAL E 

HRYAN C VAN COTT* 

KATHRYN DALLI 

LAURA I DL'NATHAN A 

LISA r.LARE k'OMBRINK 

PATRK:K P HIFE 

KELLY E k;iNIHONS 

LAUREN E. STILE3 

r^TBH'11 I RUSSELL 

BARBARA L HALL 

REZA i:BRAHlMI 

BRYAN I, DRAGO 

lOHN A OTT(.!t* 

OFilHiMSEL 

KEHt^£Tli P LAVALI.E 

KEVIN M FOX 

KAREN A.HilEG 

O -JV \ Lf. bt»s 

•) LI M IN r^i.Mios 

• «•! S S| imii 

OTHfeR OhT-li t LOi'VTIONS 

10 Main Street 

East Hampron. NY ]\9 M 

631.124 IZOO 

51 Hill Streel 

Souihampci'n, NY (1968 

611.287.1X190 

•tWWhw.'rrR.iaJ 

SuitK 565G 

Halippau;;c, NY 11786 

631.265 1414 

56H0 Mam Ro.iJ 

r.O. B.W 325 

Southold, NY 11971 

631.765.2100 

Twomey, Latham, 

Shea, Kelley, Dubin & Quartararo LLP 

- . = ATTORNEY S A T LA W 

[•.heal" sullollvkuv .rotii 

Februar y 6, 2012 

MAILIN G AHCIRESS: 

Post OtYice Box 9398 

Riverhead, New York 11W].9398 

MAIN OFFK:E: 

3 3 West Secon d Stree t 

RiverheLul. New Yoric 11901-9398 

Telephone: 631.727.2180 

P.icsimi[e: 631.727.1767 

www.sot tolUaw.com 

b y Federa l Express 

Docket Management Facility 

U.S. Department of Transportation 

1200 New Jersey Avenue, SE 

West Building Ground Floor 

Room W12-140 

Washington , DC 20590 

CO 

Re: Parts 119 and 135 Of Title 14, Air Carrier and 

Commercial Operator Requirements 

Attachment: Petition For Exemption From The 

Application Of Air Carrier And 

Coimnercial Operation Requirements To 

A Volunteer Pilot Organization's Use 

Of A Donated Aircraft 

Dear Administrator: 

Enclosed for filing is a Petition For Exemption from 

Parts 119 and 135 of Title 14 for Patient AirLift 

Services, Inc. Please date stamp the extra copy of the 

Petition and return it to me in the enclosed selfaddressed Federal Express envelope. 

Thank you. 

Very truly yours 

John w. Shea 

JFS:js 

enc. 
Patient AirLift Services 

120 Adanis Boulevard 

Farmingdale, New York 11735 

(888)818-1231 Voice and Fax 

\\ WW .j)itls<'r\ icc.s.ofy Changing the world, one flight a t a time... 

Board of Directors 

JOE HOWLEY 

CHAIRMA N 

JOH N ROCHELL E 

VICE-CHAIRMA N 

ALA N SHEINES S 

TREASURER 

HAROL D LEV Y 

SECRETARY 

DIETER DECUBA 

CHRISTOPHER 

HUNT 

RHOD A 

KUPFERBER G 

JAME S O'ROURK E 

SCOTT PAIG E 

JAME S PLAT 2 

RUTHANN E 

RUZIKA 

PETER RYA N 

JOH N SHE A 

P" 

January 31,2012 

Docket Management Facility 

U.S. Department of Transportation 

1200 New Jersey Avenue, SE 

West Building Ground Floor 

Room W12-140 

Washington, DC 20590 

Re: Parts 119 and 135 Of Title 14, Air Carrier and Commercial 

Operator Requirements 

Attachment: Petition For Exemption From The Application Of Air 

Carrier And Commercial Operation Requirements To 

A Volunteer Pilot Organization's Use Of A Donated 

Aircraft 

Dear Administrator: 

In accordance with 14 CFR § 11.63, Patient AirLift Services, Inc., a not-forprofit corporation engaged in charitable medical air transport for ambulatory 

outpatients and their escorts, respectfully submits the attached Petition for an 

exemption for the use of donated aircraft for its charitable work from the regulations of 

Parts 119and 135 regarding air carrier and commercial operators. 

Please do not hesitate to contact either of the following members of our Board 

of Directors: 

Joseph Howley 

Chairman of the Board of Directors 

Patient AirLift Services, Inc. 

120 Adams Boulevard 

Fanningdale, NY 11735 

E-mall: Joe.Howle>{^^rbssempra.com 

T: (203)312-3055 

John F. Shea, Esq. 

Member of the Board of Directors and 

Counsel 

Twomey, Latham, Shea, Kelley, Dubin 

& Quartararo, LLP 

P.O. Box 9398 

Rlverhead,Ny 11901 

E-mail: JShea@suffolklaw.com 

T: (631) 727-2180, Extension 224 

Very truly yours, 

JH:js 

enc. 

Joseph How fey 
UNITED STATES DEPARTMENT OF TRANSPORTATION 

FEDERAL AVIATION ADMINISTRATION 

X 

In The Matter Of The Petition Of 

PATIENT AIRLIFT SERVICES, INC. 

For An Exemption From Certain Provisions of Part 119 

and Part 135 Of Title 14 Code Of Federal Regulations 

X 

PETITION FOR EXEMPTION FROM THE APPLICATION OF AIR CARRIER AND 

COMMERCIAL OPERATION REQUIREMENTS TO A VOLUNTEER PILOT 

ORGANIZATION'S USE OF DONATED AIRCRAFT 

Summary of Petition 

Patient AirLift Services, Inc. (hereinafter "PALS" or "Patient AirLift"). is a not-for-profit 

volunteer pilot organization ("VPO") with approval from the Internal Revenue Service as a 

charitable organization, pursuant to Internal Revenue Code ("IRC") Section 501(c)(3). The 

primary purpose of PALS is to serve children, adults and humanitarian organizations by 

arranging free air transportation to be provided by others for access to health care and for other 

humanitarian purposes. Copies of PALS' Certificate of Incorporation and IRC Section 501(c)(3) 

approval from the Internal Revenue Service are attached as Exhibits "1 " and "2". PALS receives 

no compensation for such flights, which we provide free of charge to persons based on their 

financial need and medical requirements. 

A private party has donated an aircraft (Beechcraft Bonanza, N5463D) to PALS for use 

by PALS on flights for administrative purposes, as well as charitable flights transporting patients 

and members of the military to or from distant specialized medical evaluation, diagnostic 

services, or treatment. It is unclear whether such use of a donated aircraft is subject to the 

provisions of the regulations in Title 14 of the Code of Federal Regulations in Part 119, 

regarding the operating requirements for air carriers and/or commercial operations, and in Part 

135, regarding the requirements for equipment. 
PALS believes it is in the public's interest to allow PALS to use donated aircraft for 

charitable and administrative flights in the same manner that aircraft belonging to our volunteer 

pilots are used, without being subject to the extremely burdensome and costly requirements in 

Parts 119 and 135 that would apply to "air carriers" and/or "commercial operators." 

Accordingly, on the assumption that Parts 119 and 135 would otherwise apply to PALS' 

propose use of donated aircraft, PALS hereby petitions for an exemption from the provisions of 

the regulations in Title 14 of the Code of Federal Regulations in Part 119, regarding the 

operating requirements for air carriers and/or commercial operations, and in Part 135, regarding 

the requirements for equipment and pilots for air carriers and/or commercial operations. 

If, on the other hand, the FAA's review of this petition leads the FAA to conclude that 

the use of donated aircraft for the charitable purposes of PALS is not subject to the requirements 

in Parts 119 and 135 regarding air carrier and/or commercial operations, then PALS requests a 

written opinion from the FAA to that effect, so that PALS can operate without fear of being in 

violation of the FAA regulations. 

REASONS FOR REQUESTING THE EXEMPTION 

Members of PALS' staff travel significant distances to meet with hospital administrators, 

social workers, clinics, individual physicians and patients to establish patient referral systems 

and relationships and to coordinate actual patient transport. The coordination with the hospital 

administrators, social workers, physicians and clinics is extremely important to delivering these 

free transportation services to patients in financial need. 

Until now, PALS' staff have been dependent on the availability of volunteer pilots and 

their aircraft for such trips, or have had to drive long distances, or use public transportation to 

attend such meetings. The use of the recently donated private aircraft could greatly facilitate the 

work of our staff. 

On occasion, when other aircraft are not available, a donated aircraft could also be used 

for a PALS charitable flight. 

The aircraft can be piloted by the volunteer pilots who otherwise meet PALS' stringent 

criteria, or one of the PALS staff members, if that staff member meets the same rigorous 

qualifications that we require of our volunteer pilots. 

If the FAA were to interpret Parts 119 and 135 as applicable to PALS' use of donated 

aircraft, then, without the requested exemption, PALS would have to incur substantial expense to 

have the aircraft comply with requirements applicable to air carriers and commercial operators, 

and, in addition, the aircraft could be operated only by commercial pilots meeting the FAA 

requirements for such operations. 

We believe the requested exemption is in the public's interest, since it will greatly 

facilitate our ability to ensure that patients in financial need will be able to get essential medical 

care, sometimes of a life saving nature, and to conduct other humanitarian flights. 
The FAA recently granted an exemption to PALS from § 61.113(c) of Title 14 of the 

CFR to allow reimbursement of its volunteer pilots for fuel costs incurred in conducting PALS' 

charitable flights. (Exhibit "3"; Exemption No. 10294, Regulatory Docket No. FAA-20-0324.) 

The FAA exemption recognized that the humanitarian efforts of volunteer pilot organizations are 

commendable, and historically, the FAA has tried to encourage this kind of volunteerism and 

public service for the common good. 

Similarly, an exemption to allow the use of donated aircraft by our volunteer pilot 

organization will increase the ability of PALS to carry out its charitable and humanitarian works, 

and, at the same lime, ensure that such flights are conducted with enhanced aviation safety as a 

result of PALS' extremely stringent requirements for its pilots. Attached as Exhibit "4" is a copy 

of the pilot registration form used by PALS to register only qualified volunteer pilots and to 

schedule flights. Also attached as Exhibit "5" is a copy of PALS' Pilot Manual. 

PALS CHARITABLE FLIGHTS 

Flights arranged by PALS are dedicated to charitable purposes with a demonstrable 

public benefit. Examples of charitable flights by PALS include, but are not limited to, the 

transport of patients and escorts to distant specialized medical facilities or places of care and 

rehabilitation. PALS also helps families of servicemen, i.e., either transporting family members 

or servicemen to each other during the course of servicemen's medical care. A PALS pilot must 

note in his or her flight log the charitable purpose of the flight. 

No payments of any kind are ever made to PALS, to any PALS volunteer pilots, or to any 

other party or entity for the conduct of the flights facilitated by PALS, other than fuel 

reimbursement payments to volunteer pilots in accordance with the FAA's Exemption No. 

10294. (Exhibit "3".) 

THE PUBLIC INTEREST IN GRANTING THE REQUESTED EXEMPTION 

If PALS is able to use donated aircraft for (1) flights to carry out its administrative tasks, 

and (2) flights for patient or servicemen transport, it would greatly enhance our volunteer pilot 

organization's ability to carry out its charitable mission. That would directly benefit the public. 

IMPROVED SAFETY 

Since PALS proposes to operate a donated aircraft only with pilots who meet the high 

standards established by PALS for its operations, it would augment a culture of safety and 

increase documentation of pilot compliance, as well as VPO compliance, with safety mandates. 

By granting the requested exemption to PALS, the FAA will further promote its safety and 

regulatory objectives through our volunteer pilot organization. 
CONCLUSION 

Accordingly, if the FAA determines that Parts 119 and 135 would otherwise apply to 

PALS' use of donated aircraft, PALS requests an exemption from the application of the 

requirements for air carriers and/or commercial operations to PALS' use of donated aircraft for 

PALS administrative work and flights for charitable and humanitarian purposes. 

Respectfully submitted. 

PATIENT AIRLIFT SERVICES, INC. 

A 

ByN^ 

JosephTIowIey, OnQirman 

120 Adams Boulevard 

Farmingdale, NY 11735 

(888)818-1231 
N. Y. S. DEPARTMENT OF STATE 

DIVISION OF CORPORATIONS AND STATE RECORDS 

FILING RECEIPT 

ALBANY, NY 12231-0001 

ENTITY NAME: PATIENT AIRLIFT SERVICES, INC. 

DOCUMENT TYPE: INCORPORATION {NOT-FOR-PROFIT! TYPE: B COUNTY: NASS 

FILED:04/13/2010 DURATION:PERPETUAL CASH#:100413000338 FILM #:100413000776 

FILER: 

TWOMEY LATHAM SHEA KELLEY 

DUBIN & QUARTARARO, LLP 

3 3 WEST SECOND STREET PO BOX 93 98 

RIVERHEAD, NY 11901-9398 

ADDRESS FOR PROCESS: 

EXIST DATE 

04/13/2010 

THE CORPORATION 

2 05 ATLANTIC AVENUE 

MASSAPEQUA PARK, NY 11762 

REGISTERED AGENT: 

SERVICE COMPANY: COLBY ATTORNEYS SERVICE COMPANY - 0 8 SERVICE CODE: 08 

FEES 85.00 

FILING 

TAX 

CERT 

COPIES 

HANDLING 

75 

0 

0 

10 

0 

00 

00 

00 

00 

00 

PAYMENTS 

CASH 

CHECK 

CHARGE 

DRAWDOWN 

OPAL 

REFUND 

85 

0 

0 

0 

85 

0 

0 

.00 

00 

00 

00 

00 

00 

00 

DOS-1025 (04/2007) 
STA TE OF NEW YORK 

DEPARTMENT OF STA TE 

I hereby certify that the annexed copy has been compared with the 

original document in the custody of the Secretary of State and that the same 

is a true copy of said original. 

•••••• , 

'••-.^^T o\.y 

WITNESS my hand and official seal of 

the Department of State, at the City of 

Albany, on April 14,2010. 

Daniel E. Shapiro 

First Deputy Secretary of State 

Rev. 05/09 
DC-08 1004130«0'\'^^ 

CKRTIFICATF. OF INCORPORATION 

OF 

Patient AirLift Services, Inc. 

Under Section 403 nf the Nol-for-Profu Cnrporatinn LauTlie undersigned, for the purposes of forming a coiporaiion under Section 402 of the NoiFor-Protii Corporation Law. certifies that: 

FIRST: The name of the corporation is: 

Patient AirLift Services, Inc. 

SECOND: The corporation is a corporation as defined in subparagraph (a)(5) of 

Section 102 (Definitions) of the Not-for-Profit Corporation Law. 

THIRD: The corporation is organized exclusively for charitable, educational, and 

scientific purposes, including, for such purposes, the making of distributions to 

organizations (hat qualify as exempt organizations under section 501 (c)(3) of the Internal 

Revenue Code of 1954. as amended (hereinafter "IRC"), and the regulations promulgated 

thereunder C*the Regulations"), of the corresponding section of any future Fedenil tax 

code. Such purposes shall include, serving children, adults, and humanitarian 

organizations by ananging free air iransTWrtation lo be provided by others, tor access to 

health care and for other humanitarian purposes, and to do any other act ov thing 

incidental lo or connected with the foregoing purposes or in ad\anccnient thereof, but no! 

for the pecuniary benefit or gain of its members, directors or officers, except as permitted 

under Article 5 of the Nui-For-Profil Corporation Law. Nothing herein shall authorize 

the corporation, directly or indirectly, to engage In or include among its purposes, any of 

the activities mentioned in section 404 <a)-{w> of the Not-For-Profit Corporation Law, or 

section 460-a ol'ihe Social Services law. 

FOllRTH: The corporation shall be a type B corporation, pursuant lo Section 201 of 

the Not-for-Prot~a Corporation Law. 

FIFTH: Tlie office of the corporation is to be located in the County of Nassau, in 

the State oCNeu York. 

SIXTH: The names unO addresses of tlie initial directors of the corporation are: 

{. Joseph I lowlcy 25 Dublin Hill Road. Greenwich. CT 06830 

5 Pond View Road. Chester. NJ 07930 

319 West Lyon Farm. Greenwich. CT 06831 

23 Rogers Road. Far Hills. NJ 07931 

2 Great Falls Plax-a. Auburn. .ME 04210 

I2r, (ieiiird Drive. Fasi Ihmiplon. NY 11^37 

2. 

3. 

4. 

5. 

6. 

Alan Sheiness 

Peter Rvan 

John Rochelle 

James Platz 

Harold 1 .e\ v 

inn4i:^nnn77R 
7. Rhodz Kupferberg 1 Avery Street, Unit 29D. Boston, MA 02111 

8. John Shea P.O. Box 1413. East Hampton. NY 11937 

SEVENTH; The Secivtary of Slate is designated as agent of the corporation upon 

whom process against the corporation may be served. The address to which the Secretary 

of State shall mail a copy ofany process accepted on behalf ofihe corporation is: 

Patient AirLift Services. Inc. 

203 Atlantic Avenue 

Massapcqua Park, NY 11762 

FJGHTH: Notwilhslanding any other provisions of this Certificate of Incorporation. 

the Corporation shall not (i) conduct or carry on any activities not pemiiited to be 

conducted or carried on by an organization exempt under section 501 {c)(3)of the IRC 

and the Regulations thercuntler. (ii) make contributions to any organization which 

engages in such proscribed activities, or (iii) engage in activities which arc prohibited by 

an organization, contributions lo which are deductible under section 170 (bX 1 HA) of the 

IRC and the Regulations thereunder. 

NINTH: No substantial part of the activities of the corporation shall be curr\'ing on 

propaganda, or otherwise attempting to influence legislation (except as otherwise 

provided by IRC section 501 (h)), and the corporation shall not participate in. or 

intervene in (including the publication or distribution of statements), any polUicat 

campaign on behalfof (or in opposition to) my caiididatc tor public office. 

TENTH: No pan of the net earnings ofthe coiporation shall inure to the benefit of 

any member, trustee, director. olTicer ofthe corporation, or any private ijidividuul (except 

that reasonable compensation may be paid for services rendered to or for the 

corporation), and no member, trustee, officer ofthe corporation ofany private individual 

shall be entitled to share in the distribution ofany ofthe corporation's assets on 

dissolution ofthe corporation. 

ELEVENTH: The corporation shall have aulliority to accept as contributions 

personal pix)pcny and real property, and to receive, administer, maintain use and employ, 

in whole or in part, its income funds, securities and property, real and/or personal, as an 

association organized and operated exclusively fur charitable and educational and other 

non-profitable purposes beneficial to Uie pubhc. as such temis and purposes are used and 

defined In or in connection with section 501 (c)(3) ofthe IRC. and the Regulations, and 

to pursue such objects and purposes cither directly or by contribution lo organiz;tlions 

which qualify as exempt organizations pursuant lo the code and the Regulatitms. 

TWELFTH: Ihc private property of the dirccioi-s and officers of the corporation sliall 

not be subject to payment ofthe corporate debts to any extent whatsoever. 
1004 13000 T\\ 

Certificate of Incorporation 

of 

Patient AirLift Services, Inc. 

Under Section 402 ofthe Not-for-Profit Corporation Law 

STATE C'F HEW YCtP.K 

Di^FvVnMtNTGF STATE 

I t-1 LI . i--* 

AfR 13 2019 

TAX$. 

EY:, 

Filed By: 

Twomey, Latham, Shea, Kelley, Dubin & Quartararo, LLP 

33 West Second Street - P.O.Box 9398 

Riverhead NY 11901-9398 

^ 

D.C.-08 BOUTINE 

DRAWDOWN 

24 HOUR 

• SAME DAY 

• 2 HOUR 

^3r 
INTERNAL REVENUE SERVICE 

P. O. BOX 2503 

CINCIN>IATI, OH 45201 

'JEPARTMSNT OF THE TREASURY 

Date MAY 1 1 2010 

PATIENT AIRLIF T SERVICES INC 

2 0 5 ATLAfJTIC AVE 

MAGGAPEQUA PARK, MY 117i52 

ET.jjioye r IdeP.'ciCicacio n Nui^iljer • 

27-2370028 

DL.N • 

1''053120J1300'-J 

ConzacC Perso:: : 

RENEE RAILEY NORTON ZDir 3Ji7:-! 

Contac^, Telephone Number: 

(877) 829-5500 

Accounting Period Ending; 

December 31 

Public Charity Status; 

170(b}(1)(Al(vi) 

Forrr' 99C Required: 

Yes 

Effective Date of ExempLio:i: 

April 13, 2C10 

Con::rilrution H'eriuct ib L 1 . c y 

Yes 

Addendum Applies: 

No 

Dear Applicant: 

We are pleased to inform you cnat upon review of your application for tax 

exemp t StaLuti w e havis dccevmin-ed -ha C yoi-i ar(= e>-Gfnpt: fro m Ft^dp^r^l i.ncoi'ie ta:.: 

under section 501{d (3) of Che InCernal Revenue Code. Contributions to you are 

deduct! bie under section 170 of t.h.e Code . You are also gual i f ied z o receive 

tax deductible bequesiis , devises , t rans f er s or gifts binder te'-'t: 

or 2522 of the Code . Because chis l^itt-er could h-^lp resol-.^e an / qa'^sl;:Lon.s 

regarding your exerrpi status, you should keep it in your permart r c t d'J 

Organizations exempt under section 501(c)(3) of the Code are further classified 

3S eitiier public charities or private foundations. We determined that you are 

a public charity under the Code seccion(s) listed m the heading of this 

letter. 

Please see enclosed Publication 4221-PC, Compliance Gu^de for S 01 (C1 '-J,] Public 

Charities, for some helpful information about your responsibilities as an 

exempt organization• 

14 . DO, c; 
PATIENT AIRLIFT SERVICES IKC 

Sincerely, 

Robert Cho:L 

Director, Exenpt Organizations 

Rulings and Agreements 

Enclosure: Publication 4221-PC 

Letter 94 ' (DOC' 
Q 

U 5 Deportmenf 800 independence Ave SW 

ofTronspOftalon Washington. DC 20591 

Federal Aviation 

Administration 

.lune22.20n 

Exemption No. 10294 

Regulatory Docket No. FAA-2011-0324 

Mr, Joseph Howley 

Chairman ofthe Board of Directors 

Patient AirLift Services, Inc. 

120 Adams Boulevard 

Farmingdale. NY 11735 

Dear Mr. Howley: 

This letter is to inform you that we have granted your request for exemption. It transmits our 

decision, explains its basis, and gives you the conditions and limitations ofthe exemption, 

including the date it ends. 

The Basis for Our Decision 

By letter dated March 24, 2011, you petitioned the Federal Aviation Administration (FAA) on 

behalf of Patient AirLift Services, Inc. (PALS), for an exemption from § 61.113(c) of 

Title 14, Code of Federal Regulations (14 CFR) to the extent necessary to allow for 

reimbursement of its volunteer pilots for fuel costs incurred in conducting charitable flights. 

The FAA has determined that good cause exists for not publishing a summary ofthe petition 

in the Federal Register because the requested exemption would not set a precedent, and any 

delay in acting on this petition would be detrimental to PALS. 

The FAA has issued grants of exemption in circumstances similar in all material respects to 

those presented in your petition. In Grant of Exemption Nos. 10009 and 10019 (copies 

enclosed), the FAA found that the humanitarian efforts of these pilots who volunteer their 

time and piloting services are commendable, and the FAA wants to encourage this kind of 

volunteerism and public service for the common good of our citizens. The FAA recognizes 

the fact of rising costs for fuel and aircraft operating expenses; however, when money is 

exchanged for transportation, the public expects, and the FAA has a duty to demand, a higher 

level of safety for the flying public. The FAA believes by requiring the petitioners and their 

AFS-n-314-E 
pilots to comply with the conditions and limitations set forth in this grant of exemption, the 

FAA can ensure that a higher level of aviation safety for the flying public will be maintained. 

Having reviewed your reasons for requesting an exemption, I fmd that— 

• they are similar in all material respects to relief previously requested in the enclosed Grant 

of Exemption Nos. 10009 and 10019; 

• the reasons stated by the FAA for granting the enclosed Grant of Exemption Nos. 10009 

and 10019 also apply to the situation you present; and 

• a grant of exemption is in the public interest. 

Our Decision 

Under the authority contained in 49 U.S.C. 40113 and 44701, which the FAA Administrator 

has delegated to me, I hereby grant Patient AirLift Services, Inc., an exemption from 

14 CFR § 61.113(c) to the extent necessary to allow for reimbursement of its volunteer pilots 

for fuel costs incurred in conducting charitable flights, subject to the conditions and 

limitations described below. 

Conditions and Limitations 

1. The exemption holder must have in place the following: 

a. A structured and documented pilot registration process that has an annual 

rene\v'al requirement and ensures that only qualified pilots who are registered 

and trained conduct charitable flights. This process must include a means to 

verify registration prior to flight; 

b. On-file documentation authenticating registered pilots' experience, ratings, 

FAA physical, and any other information pertinent to the pilots" qualifications; 

c. A system that registers the pilot's assertion, at the time he/she accepts a flight 

to accomplish, that he/she meets all minimum standards and appropriate 

cunency requirements established by the FAA and all conditions and 

limitations set forth in this exemption and will conduct the flight in accordance 

with all applicable Federal regulations; and 

d. A file of all flight and reimbursement records that must be made available to 

the FAA for viewing at a designated office site location. Records shall be kept 

a minimum of 2 years. 

2. The FAA may. at any time or place, conduct inspections ofthe pilot(s) and aircraft 

being flown in accordance with this exemption, 

3. All pilots must possess the following qualifications and aeronautical experience, as 

appropriate: 
a. Must hold an instrument rating or privilege (i.e., instrument privilege relates to 

the airline transport pilot certificate) that is appropriate to the aircraft being 

tlown; 

b. For the operation ofany single-engine piston aircraft, the pilot shall have a 

minimum total time of 500 hours, with no less than 400 hours as pilot in 

command (PIC), and a minimum of 50 hours in the specific make and model of 

single-engine aircraft being flown; 

c. For the operation ofany multiengine aircraft, a minimum total time of 1,000 

hours as PIC, a minimum of 250 hours in multiengine aircraft, and a minimum 

of 50 hours in the specific make and model of multiengine aircraft being 

flown; 

d. For the operation ofany turbine-powered aircraft, a minimum total time of 

1,000 hours as PIC, a minimum of 100 hours in turbine-powered aircraft, and a 

minimum of 50 hours in the specific make and model of turbine-powered 

aircraft being flown; 

e. A minimum of 50 hours as PIC shall have been flown and logged within the 

preceding 12 calendar months immediately preceding the month ofthe flight; 

f. Minimum of 12 hours flown and logged, or 2 hours of dual flight training with 

a certiflcated flight instructor, within the preceding 3 calendar months prior to 

the month ofthe flight; 

g. Must hold a 2nd class medical certiflcate (per §§ 61.23(d)(2)(i) and 61.2); 

h. Must have a current flight review (per § 61.56(a)) in the same aircraft 

categor>', class, and type (if a type rating is required) being flown; 

i. Shall be instrument-current (per § 61.57(c) or (d), as appropriate) in the same 

aircraft categor>% class, and type (if a type rating is required) being flown; 

J. Within the preceding 3 calendar months prior to the flight, the piiot(s) must 

have logged at least three takeoffs and three landings to a full stop in the same 

aircraft category, class, and type (if a t>'pe rating is required) being flown. 

However, this condition may be accomplished by logging at least 

three takeoffs and tliree landings to a full stop at night within the preceding 

3 calendar months in the same aircraft category, class, and type (if a type 

rating is required) being flown; and 

k. For all operations under this exemption, the pilot must be current for night 

operations (per §61.57 (b)) in an aircraft ofthe same category, class, and t>'pe 

(if a type rating is required). 
4. Flight duty, rest, and flight time limitations: 

a. No pilot may fly more than 8 hours of flight time (per § 61.1) within any 24-

consecutive-hour duty day period; 

b. No pilot may perform a duty day in excess of 12 consecutive hours (a duty day 

starts when the pilot arrives at the airport and begins preparation for the flight 

and terminates upon completion ofthe post flight ofthe aircraft); and 

c. Once the pilot has performed 12 consecutive hours of duty, the pilot must rest 

a period of at least 12 hours before conducting another flight. 

5. Passenger and medical crew briefing requirements: Prior to each takeoff, the PIC 

must ensure that all passengers have been orally briefed on the following: 

a. The flight is being permitted under this grant of exemption and that the 

operator is not a certificated commercial operator; 

b. Smoking; When, where, and under what conditions smoking is allowed; 

c. Use of safety belts, shoulder harnesses, and child restraint systems: When, 

where, and under what conditions it is necessary to have his or her safety belt 

and, if installed, his or her shoulder harness fastened about him or her; 

d. The placement of seat backs in an upright position before takeoff and landing; 

e. Location and means for opening the passenger entry door and emergency exits; 

f. Location of survival equipment; 

g. Use of normal and emergency oxygen installed; 

h. Location and operation of tire extinguishers; and 

i. Prior to each takeoff, the PIC must ensure that the patient, who may need the 

assistance of another person to exit the aircraft if an emergency occurs, has 

received a briefing as to the procedures to be followed if an evacuation occurs, 

6. Pilot training: The exemption holder must establish an initial pilot training program 

that includes the following elements. All pilots must complete this training program 

prior to conducting flights under this grant of exemption: 

a. Risk, hazard identification; 

b. Accident trends and factors for general aviation tlxed wing under 

12,500 pounds; 

c. Current edifion ofthe Aircraft Owners and Pilots Association Air Safety 

Foundafion Nail Report; 

d. High risk phases of flight— 

i. Takeoff and climb; 
ii. Takeoff stall/settling; 

iii. Loss of airspeed resulting in nonrecoverable stall or sink rate; 

iv. Loss of control; and 

V. Crosswinds/otlier conditions leading to loss of directional control; 

e. Maneuvering— 

i. Stall or loss of control; and 

ii. Loss of airspeed resulting in stall/spin; 

f. Descent/approach: Beginning of descent from cruise altitude to missed 

approach point or runway threshold; 

g. Stalls/spins; 

h. Loss of airspeed; 

i. Collisions with objects, terrain; 

j . Loss of engine power; 

k. Carburetor icing (if appropriate, for the aircraft the pilot is assigned to fly); 

1. Incorrect fuel mixture; 

m. Wind gusts or wake turbulence; 

n. Landing— 

i. Loss of directional control; 

ii. Crosswinds; 

iii. Inadequate airspeed control; 

iv. Stalls, hard landing, short-long touchdown; 

V. Runway conditions; and 

vi. Runway contamination; 

o. Flight plamiing and decisiomnaking— 

i. Flight planning; 

ii. Improper pre-flight planning; 

iii. Insufficient fuel reserves; 

iv. Inadequate in-flight monitoring of ground speed; 

V. Systems operation; 

vi. Improper operation of fuel system; 

vii. Fuel contamination; 
viii. Improper fiieling; 

ix. Weather; 

X. Continued visual flight rules into instrument meteorological conditions; 

si. Deficient instrument flight rules (IFR) technique; 

xji. Failure to follow appropriate IFR procedures; 

xiii. Descending below minimum descent altitude on approach; 

xiv. Thunderstorm; 

XV. Flying too close or penetrating turbulence; 

xvi. High winds; 

xvii. Mountainous terrain; 

xviii. Icing; 

xix. Loss of lift and perfonnance; and 

XX. Instrument malfunction; 

p. Other factors — 

i. Single pilot IFR; 

ii. Night operations at unfamiliar airports: 

iii. Mission mentality; 

iv. Pressure to complete flight operations; 

v. Distractions; 

vi. Missed approach/go around; 

vii. Incomplete/stale weather brietlngs; 

viii. Communications processes, decisions, and coordination, to include 

communication with air traffic control and passengers; 

ix. Workload and time management; 

x. Simational awareness; 

xi. Effects of fatigue on performance, avoidance strategies and 

countermeasures; 

xii. Effects of stress and stress reduction strategies; and 

xiii. Aeronautical decisiomnaking and judgment. 

7. Recurrent training: An annual recurrent training program must ensure: 
a. The pilot remains adequately trained, current, and proficient regarding all of 

the elements contained in the exemption holder's training program; 

b. Recurrent training must include testing to determine the crewmember's 

knowledge ofthe aircraft and the exemption holder's program; and 

c. Recurrent flight training sufficient to satisfactorily complete the recurrent 

proficiency flight check. 

8. Aircraft requirements: Each aircraft must have a standard airworthiness certificate. 

9. Aircraft maintenance: AM maintenance must be performed by a certificated mechanic, 

repairman, or repair station. Aircraft components must be overhauled prior to 

reaching manufacturer's recommended time between overhaul. 

10. Areas of operations: All flights must remain within domestic United States airspace. 

11. All pilots must adhere to the following best practices policies ofthe exemption holder 

which are: 

a. In instrument meteorological conditions (IMC) conditions, each pilot must 

plan to land at airport with a precision approach; 

b. Each pilot must add 100 feet to all instrument approach minimums; 

c. For night landings, the pilot shall use runways with functional vertical 

guidance (visual approach slope indicator, precision approach path indicator, 

instrument flight system); 

d. Pilot will not attempt circling approaches at night; 

e. Add 50 percent to pilot operating handbook runway length performance to 

clear the obstacle for takeoff and landing under ambient conditions; 

f. For IMC takeoff minimums. the pilot must apply 50 percent above the 

approach landing minimums (example: Baltimore-Washington International 

Airport minimums 200/1/2, then the takeoff minimums will be at least 300 feet 

and 3/4-statute-mile visibility); 

g. If destination is unfamiliar, the pilot must obtain briefing from a pilot or fixedbase operator with experience with that airport prior to flight; 

h. Pilots are requested to use nonpunifive report process to communicate any and 

all situations when safety of flight was compromised; 

i. Pilots are requested to provide feedback on weather, airports, air traffic 

control, other pilots, etc., that could compromise safety for future flights; 

j . The pilot must ensure that all passengers are restrained by FAA-approved 

seatbelts or FAA-approved child safety seat. The only exception shall be 

change of seat positions, quick access to luggage, care and/or feeding of child, 

or use of lavatory; 
k. Pilots will consult all available weather products, wind sock, etc., to verify 

departure will be from the correct nmway relative to wind conditions; 

I. Pilots will utilize computer devices and reading material only as these are 

pertinent to safe operation ofthe flight and will refrain from any and all 

distractions that could compromise safety of flight; and 

m. Pilots will utilize and brief passengers that a sterile cockpit condition exists 

during taxi and takeoff until reaching cruise altitude and also during descent 

from cruise altitude, descent, approach, landing, and taxi to ramp. 

12. Pilots must complete and adhere to the Go/No-Go checklist, patient, passenger, copilot release forms, and post-flight report. The Go/No-Go checklist will consist of at 

least the following information: 

Pilot Go/No-Go Checklist 

EXCELLENT OK MARGINAL POOR 

Pilot 

Physical health 

Mental health 

n 

n 

D 

D 

n 

n 

n 

n 

Prepared/Confident 

Well rested 

D 

D 

n 

D 

n 

D 

n 

D 

Aircraft 

Maintenance 

Fuel reserve 

G 

D 

D 

n 

D 

• 

n 

n 

Pre-flight n D D D 

Equipment sufficient for the • 

flight conditions 

D n D 

Weight and balance Takeoff weight/CG_ 

Landing weight/CG 

Weather 

EXCELLENT OK MARGINAL POOR 
Current & WX Forecast • p n • 

Conditions 

Departure • a n c 

Destination D an a 

Return n • a • 

Explain if Marginal or Poor: 

Other 

Child safety seat 

Passengers briefed 

Pre-departure weather briefing 

Verify departing on correct runway 

Release forms signed 

Flight # 

Pilot Signature 

Date 

YES No 

The checklist must be provided to the exemption holder or left with a responsible person, 

such as a fixed-base operator, prior to conducting a flight under this exemption. The 

completed checklist must be retained for 3 days. 
10 

13. Flight locating procedures required: The pilot must file and activate an IFR flight plan 

for each flight. The flight plan may be canceled upon acceptance of a visual approach 

clearance from air traffic control. 

This exemption terminates on .lune 30. 2013. unless sooner superseded or rescinded. 

Sincerely. 

/s/ 

Melvin Cintron 

Acting Deputy Director. Flight Standards 

Service 

Enclosures 
PILOT AFFIRMATION 

I promise not to act as a Patient AirLiA Services Command Pilot as pilot-in-command ofany 

flight referred to me by Patient AirLift Services unless at the time of each such flight: 

1. I hold a valid and current pilot certificate for the aircraft category, class and type (if a 

type rating is required) in which I will be acting as pilot-in-command. 

2. I bold at least a valid and current Class lH medical certificate 

3. I am IFR rated, current and qualified in the aircraft category, class and type (if a type 

rating is required) to be flown. 

4. I am in compliance with all Federal Aviation Regulations, including those regulations 

relating to currency for canying passengers, fli^t reviews, night flying, ftiel reserves and 

instrument flight. 

5. I am in compliance with all Federal Aviation Regulations relating to the use of alcohol 

and drugs, including reporting requirements specified in the regulations. 

6. Whether flying rented or owned aircraft, 1 have in force liability insurance applicable to 

the flight providing minimum coverage of $1,000,000 per occurrence and $100,000 per 

seat. 

7. I am flying an airplane with a valid standard airworthiness certificate (normal, utility, 

acrobatic, commuter or transport category). 

8. If I am renting an aircraft for the mission, I attest that I have satisfied the requirements 

and conditions ofthe rraiting agency. 

9. I have flown a minimum of 12 hours as PIC during the 90 days immediately preceding 

the mission, or in the alternative, I have completed 2 hours of dual training with a 

certified flight instructCM* widiin the preceding 3 calendar months prior to the month of 

flight. (This 12 hours is included in the total of 50 and is not additional) 

10. I am in compliance with the Patient AirLift Services Manual. 

I understand that it is my responsibility and obligation to decline to serve as pilot-in-command on 

any flight referred to me by Patient AirLift Services unless ALL ofthe above statements are true 

at the time ofthe flight. 

Pilot Name (print) Membership Number: 

Signature: Date; 

This document is to be signed and mailed to PALS alor^ with all passenger waivers and a W&B on each mission flown. 

Last created 3-24-2011 

Patient AirLift Services 

Piiot Handbook 

Tabie of Contents 

Welcome to the PALS Team 3 

Introduction - Frequently asked questions 4 

Volunteer Opportunities 7 

Requirements to Fly as a Pilot in Command 8 

Liability Releases and Guardian Authorization 10 

How to Login to AF IDS 11 

Mission Assignment Procedures 13 

Mission Preparation - Checklist 14 

Linked Missions 17 

Use ofCompassion Flight Call Sign 18 

Use of Lifeguard Call Sign 19 

Crisis and Risk Management 20 

Mission Photos, Fee Waivers and Fuel Discounts 21 

Post Mission Procedures 22 

Pilot Checklist of Dos and Don'ts 24 

Attachments 

A: Pilot Application Checklist 26 

B; Sample AFIDS Sign on Screen 27 

C: Sample Mission Itinerary 28 

D: Sample Post Mission Report 29 

-2-
Dear Pilot: 

On behalf of the PALS Board of Directors and Staff, welcome and thank you for your interest 

in volunteering! When you take the gifts of your talents and skills as a pilot and use them to 

benefit others, you will be embarking on some of the most rewarding experiences of your life. 

As a PALS pilot, you will be flying people who would not be able to receive the medical or 

compassionate assistance for which they are so urgently in need. 

We recognize that PALS would not exist without the gift of time, energy and enthusiastic 

support from volunteers like you. We understand that your schedule may only permit you to do 

one flight a month or one flight a year; either way, your efforts are greatly valued. The PALS 

Board and Staff plan to establish a volunteer support system that includes communication via 

our website, emails, and pilot meetings. You will get to know the patients, but you will also 

meet your fellow pilots, share flight experiences, provide feedback, and have fun! 

I would encourage you to visit the website www.palservices.org to review our Bylaws, 

Conflict of Interest Policy, and other filings. We hope this will assure you that we are 

committed to be a transparent organization. Our prime focus is to serve patients and support 

pilots. 

Thanks again for joining our team! I look forward to meeting you personally. 

Welcome to the PALS TEAM. 

Sincerely, 

Joe 

Joe Howley 

joe.howley@palservices.org 

Chairman, Patient AirLift Services 

-3-
What is Patient AirLift Services? 

Patient AirLift Services (PALS) arranges free air transportation based on need to individuals 

requiring medical care and for other humanitarian purposes. We have a network of volunteer 

pilots who provide this service without reimbursement or compensation using their own or 

rented aircraft. No fees ofany kind are charged for these services. 

Generally the individuals who utilize our services are receiving diagnosis, treatment or followup for various types of acute or chronic illnesses that make it either financially impossible or 

otherwise infeasible to use public commercial or private charter transportation. 

PALS* foimders have extensive experience with volunteer flying. Among them, they have 

flown thousands of missions as pilot-in-command. Although the pilots donate their time, 

airplanes and all expenses without compensation, the organization needs to maintain a 

coordination center in order to connect people to pilots and oversee the missions. Our only 

sources of income to operate this center are private donations and grants. 

It is from the generous contributions from people like you that we are able to be here for those 

who seek our services 

PALS is a 501(cK3) tax-exempt public charity and a member ofthe Air Care Alliance. 

What kind of aircraft does PALS tvpicaUv utUize? 

Aircraft used for PALS flights are typically single- or twin-engine, propeller-or Uirbo prop 

driven aircraft. 

Missions flown for PALS have the same status as any flight made with passengers by a private 

pilot under Part 91 of the Federal Aviation Regulations and the "Good Samaritan" Act. 

Liability is the same as a flight for friends or family. 

What are the Insurance Requirements? 

PALS Pilots, whether they are owners or renters, are required to have liability insurance in 

order to fly as the pilot in command of a mission. See the pilot requirements page for specifics. 

Note: PALS does not carry additional aircraft liability insurance. Ail passengers flown by 

A -
PALS are required to sign a waiver of liability naming both the pilots and the Patient AirLift 

Services organization. Since there is no remuneration for the flights, they are non-commercial 

and covered imder a pilot's normal liability policy. 

Who Pays for the FUshts? 

Pilots are responsible for all mission costs. These costs are tax deductible for the pilot as a 

charitable donation. Many FBOs offer fuel discoimts and most airports waive landing and 

parking fees for pilots on PALS missions. 

The passeQger(s) is responsible for arrangements and costs for all non-flight needs, including 

ground transportation and lodging. The PAL pilot incurs no more expense dian he or she would 

incur on an equivalent business or pleasure flight. 

What is PALS' Territory? 

PALS covers flights in the entire Northeast United States as far west as Ohio and as far south as 

Virginia. Typical flight times in oiu" general aviation aircraft will range from two to three hours 

per leg, covering 200-600 miles. Flights originating or terminating beyond our primary 

coverage area will be conducted by our member pilots, or will be coordinated witii other similar 

organizations to provide you the patients with a seamless travel itinerary. 

What Happens if I Am Unable to Flv a Mission? 

PALS, believes in Safety First, therefore a pilot is fi^e to and should decline any mission they 

feel they are imable to safely complete. Reasons for declining a flight could be personal health, 

scheduling, weather, or other personal reasons. We encourage pilots to recognize then- limits, 

and to fly only when they feel completely comfortable doing so. You will never be questioned 

as to why you cancel a flight; that will be your call! 

When unable to fly as PIC, pilots can choose to participate as copilots. 

How wiU I be identified as a PALS Pilot? 

All ofthe PALS crewmembers, both pilot and non-pilot, which have participated in at least one 

PALS mission, are eligible for a PALS photo ID badge. A badge can be requested by sending 

an email to info(^palservices.org imless there was an ID photo of you taken during your 

orientation, be sure to include a color jpeg photo of yourself as an attachment to the email The 

photo should be a passport type headshot there is no charge for the badge. 

The ID badge will be supplied with a PALS lanyard that allows it to be worn aroimd your neck. 

A clip that can be used to attach the badge to your clothing is also included. 

While PALS crewmembers are not required to wear an ID badge during PALS missions, they 

are encouraged to do so. In addition to being an aid for airport security*, the badge identifies 

the crew as PALS members, which helps promote community awareness of Patient AirLift 

Services. The badge can also be useful to pilots when requesting fuel discoimts and the 

reduction or waiving of landing and aux:raft parking fees. 

- 5-
*It is mandatory that the pilot and everyone else on board the aircraft must carry appropriate 

identification for airport security purposes, including at least one photo ID. 

Can I deduct mv flight expenses on mv taxes? 

Yes, PALS is a 501(cX3) tax-exempt public charity and as such, contributions, including the 

costs of flying missions, are therefore deductible. Pilots can deduct direct, out-of-pocket 

expenses. If overnight lodging is required, that expense, along with meals, is also deductible. 

Accurate records must be maintained, including receipts, hours flown, destination, ete. On page 

29 you Can see a sample ofthe Mission Report Detail, which you can use for your tax records to 

verify your flight. For complete information regarding deductible items and documentation, 

pilots should consult a tax professional. 

What types of ilhiesses can I expect to encounter? 

ninesses vary. Some patients have Ufe threatening diseases, such as cancer or heart disease. 

Others have illnesses that require specialized treatment at distant locations due to the fact there 

may only be several specialist in the world that can help. Illnesses are non-communicable 

(cancer, heart disease, brain tumor, etc.). However, occasionally this is not the case. PALS 

pilots will be made aware of these types of situations, allowing the pilot to determine if he/she 

is still willing to fly the mission. 

PALS requires patients who qualify for our assistance to be ambulatory, able to sit upright for 

the duration of the flight, and in need of very little assistance. In cases where more attention is 

needed, patients make arrangements to be accompanied by an attendant. If the patient is a child, 

we require an adult guardian to be present as well. 

Rarely do passengers require oxygen, but in the case of those who do, personal oxygen bottles 

are not allowed imless the bottle carries a DOT cerdflcation for use aboard an aircraft. Some 

FBOs have oxygen available, and pilots with an approved oxygen system onboard the aircraft 

may, if they choose, make it available for patients. However, permission from the patient's 

physician must be obtained before either a rented or onboard system can be used. 

How do flights actually get "put together?" 

Requests for assistance can begin in several ways, either by phone, or computer request. 

Request might come from a potential passenger directly, from one of the many medical 

facilities or social workers with whom PALS maintains relationships. Once the request has 

been received our mission coordination staff will begin the process of intake, listing, assigning 

and completing the flight request. 

Our Mission Coordination staff will initially screen the call, making certain the passenger 

qualifies for a PALS flight, as someone who is in fmancial need, has a legitimate need for air 

transportation, and is able to fly in a general aviation airplane. Once they determine this is a 

valid request, they will enter all the pertinent info into the Mission Coordination computer 

system where the pilots can access the available missions. When a pilot chooses a flight, it gets 

assigned to diem and they are forwarded all necessary info, at which point they become the 

point person for the patient regarding the flight details. 

. z ^ 
Volunteer Opportunities 

The Members of Patient AirLift Services consist of both pilots and non-pilots, who share 

common characteristics and the heartfelt desire to help those in need. There is a great need for 

Non Pilot volunteers, and there are a number of ways in which our non-pilot volunteers can 

help out: 

AutoPUots - Help out by providing ground transportation between air terminals and 

medical treatment centers. This is a huge asset to the patients who generally have no resources 

to get to and from the treatment centers. For more information contact us at 

infou^palscrvices.org or by dialing 1 -888-818-1231 

Outreach - The outreach volunteers help us by spreading the PALS word to hospitals 

and community members such as Veteran's Organizations or local chapters of health 

awareness/support/treatment organizations who deal with patients. The task could be 

something as simple as dropping off brochures to these types of organizations in your area. For 

more info contact cilecn.minogucftfjpalscrviccs.ori;: or 1-888-818-1231 

Fundraising- We are always looking to have small fundraising events throughout the 

area in which we serve. These events not only generate fimds to help us accomplish our 

mission, but they enable us to continually reach different neighborhoods who might not know 

about our service, but might very well benefit from it. For more info contact 

cilccn.minogiic(fV:DalsL'rviccs.org or 1-888-818-1231 

Disaster/Humanitarian Response Volunteer - PALS Pilots have a long history of 

being some of the first responders during times of national disasters, and humanitarian efforts 

such as the recent Haitian Earthquake. Ehiring these times, there is a great need and influx of 

requests to get a lot of planes in the air in a short period of time. 

Our disaster & Humanitarian Response Volunteers can work from their homes or offices 

to help us notify pilots, schedule flights, and act as a support system to our mission coordination 

staff. You might also be asked to help coordinate our efforts on the ground as well. For more 

info contact cilccn.minoguc(ajpalscrvices.org or 1-888-818-1231 

General office help - Our offices are located on Long Island and we are always in need 

of volunteers to help out with filing, paperwork, and general office needs. For more info 

contact eilcen.minoguc(i:f;palscn. ices.org or 1-888-818-1231 

Our mission is large, and we consider every volunteer to be a great 

asset to our efforts to help those in need. 

If you are interested in becoming a volunteer, please fill out the volunteer application and mail 

it to: 

Patient AirLift Services 

120 Adams Boulevard 

Fanningdale, NY 11735 

For more information call: 1-888-818-1231 or 516-300-1660 

- 7 -
Command Pilot Requirements 

The Board of Directors has established the following pilot requirements 

for acting as Command Pilot on a PALS mission: 

(1) For the operation of any single engine piston aircraft, the 

pilot shall have a minimum total time of 500 hours, with not less 

than 400 hours as pilot-in-command (PIC), 50 hours of such PIC 

time having been in the same make and model aircraft. 

(2) For the operation of any multi-engine or turbine powered 

aircraft the pilot shall have a minimum total time as pilot-incommand (PIC) of 1,000 hours, with a minimum of 250 hours in 

type for a twin engine aircraft and 100 hours in type for a single 

engine turbine aircraft but not less than 50 hours in make and 

model, unless dispensation shall have been previously granted to 

said pilot by the Safety Committee, but in no event shall such 

dispensation be for less than the qualifications as set forth in 

paragraph (1) above. 

(3) In addition, for each mission to be flown the pilot shall 

afTirm currency and adherence to applicable FARs as set forth in 

the PALS Pilot Affirmation form (example follows). 

-8-
I promise not to act as a Patient AirLift Services Command Pilot as pilot-io-command ofany flight 

referred to me by Patient AirLift Services unless at the time of each such flight: 

I. I hold a valid and current pilot certificate for aircraft category, class and type (if a type rating is 

required) in which I will be acting as pilot-in-command. 

I hold at least a valid and current Class m medical certificate 

I am IFR rated, current and qualified in the aircraft category, class and type (if a type rating is 

required) to be flown. 

I am in compliance with all Federal Aviation Reguladons, including those reguladons relating to 

currency for canying passengers, fUght reviews, night flying, fuel reserves and instrument 

flight. 

I am in compliance with all Federal Aviation Regulations relating to the use of alcohol and 

dmgs, including reporting requirements specified in the regulations. 

Whether flying rented or owned aircraft, I have in force liability insurance apphcable to the 

flight providing minimum coverage of $1,000,000 per occurrence and $100,000 per seat 

I am flying an airplane with a vaUd standard airwortiiiness certificate (normal, utility, acrobatic, 

commuter or transport category). 

If I am renting an aircraft for the mission, 1 attest that I have satisfied the requirements and 

conditions ofthe renting agency. 

I have flown at least 50 hours as pilot-in-command in the last 12 calendar months. 

10. I have flown a minimum of 12 hours as PIC during the 90 days immediately preceding the 

mission, or in the altemative, I have completed 2 hours of dual training with a certified flight 

instructor within the preceding 3 calendar months prior to the month of flight. (This 12 hours is 

included in the total of 50 and is not additional) 

II. 1 am in compliance with the Patient AirLift Services Manual. 

5. 

6. 

7. 

8. 

9. 

I understand that it is my responsibility and obligation to decline to serve as pilot-in-command on any 

flight referred to me by Patient AirLift Services unless ALL ofthe above statements are true at the time 

ofthe flight. 

Pilot Name (print) Membership Number: 

Signature: Date: 

This document is to be signed and mailed to PALS along with ail passenger waivers and a W&B on each jnissionftown. 

JIJL 
UabilHv Waiver and 6iianilan AultM»Hyafinn 

Liability waivers and guardian authorizations are used to protect the individuals (including the 

pilot) and organizations (including Patient AirLift Services) involved in PALS flights from any 

liability resulting from their participation in these volunteer, uncompensated missions. A signed 

Uability waiver for each adult and a signed guardian authorization for each minor must be 

obtained fix)m every passenger on every PALS flight prior to the flight's departure. This 

includes copilots who are not PALS members. 

The only exception to having forms signed for every flight is round trips going nonstop from 

the departure airport to the destination airport and later returning nonstop to the departure 

airport on the same day, carrying the same passengers. In those instances, at the pilot's 

discretion, liability waivers and guardian authorizations are required only prior to the beginning 

ofthe first leg. 

A single liability waiver form can be used for either one or two adult passengers. A separate 

guardian authorization form is required for each minor passenger. 

These forms, along with a signed pilot affirmation and written aircraft weight and balance 

calculation for the upcoming flight, must be mailed or 

faxed to PALS before the flight departs. These 

documents are not to be taken on board the aircraft 

mdess previously sent to PALS. 

At the bottom of the liability release is a place for the 

patient or other passengers to initial (or the patient's 

guardian to initial, in the case of a guardian authorization) 

that allow the patient's and other passengers* names and/or 

photographs to be used by PALS for public relations 

purposes. If the patient or passenger, or patient's guardian, 

does not initial this permission request, their names and 

photographs will not be used. 

Note: Waiver and Guardian Authorization 

forms are maintained at and can be 

downloaded from the Pilot page on the 

PALS website. 

aiLi 
How to lotfin ftw your Mission 

When all paperwork has been filled out and you are ready to fly your first mission, you can do 

so by going online to the PALS pilot website at www.palscrviccs.org and clicking on 

"Available Missions" or by using the PALS AFIDS (our Mission Coordination System) logon 

directiy, signing in, and then going to the "Missions Available" link on the left hand side ofthe 

AFIDS home page. The first time you log in to AFIDS, you will need your PALS Member ID 

Number, your last name and your zip code as provided on your PALS application. 

Once you have logged in as a member with your ID#, you should give yourself a Useraame and 

Password. After you have completed this step, you must next log in using your chosen 

usemame and password every time you login in the future. You will not be able to login using 

your ID# after your initial login. This process helps us maintain a higher level of security for 

AFIDS. If you forget your password, click on the link on the login page and your password 

will be emailed to the email address we have in the system. 

Links to various AFIDS functions are located on the left blue bar that you will be able to view 

and use once you've logged in to AFIDS. 

File mission reports 

Missions Available 

Missions Pending 

Missions Visual 

Manage E-mail subscriptions 

Block Mass Emails 

Un-block Mass Emails 

Mission Summary Year End Report 

Edit your Data 

MOP Directory 

Member Roster 

Renew Your Membership 

Other features will be added periodically to improve the system. 

Al ^ 
To select a mission: 

• You can select a mission by clicking on "Available Missions" on the left-hand 

column on the www.palservices.org pilot's page, or by using the PALS AFIDS logon 

directly, signing in, and then going to the "Missions Available" link on the left hand 

side ofthe AFIDS home page. 

• Once you find an open mission that you are interested in, click on the word 

"open" next to that mission. Once the mission is selected, you will be prompted to login 

to AFIDS. 

• Follow the login instructions listed above. 

• Review the mission and select "Request this Mission" at the bottom of the page. 

• On the Mission Request page, insert any comments you may have and select the 

"add" button at the bottom ofthe page. 

• You will then receive a confirmation email along with the mission's paperwork 

fix>m the Mission Coordinator letting you know your message was received. If the 

mission is already filled, you will also receive an email from the Mission Coordinator 

notifying you ofthe mission's status. 

• Once the mission has been assigned to you, as confirmed by a coordinator, 

please follow the Pilot in Command Suggested Checklist included in this handbook. 

You can get more out of flying than just being able to fly! 

Thank you for being a part of the PALS team! 

jdZj^ 
Mtealon Asaltfnmeirt Procedureg 

Once a mission has been assigned to a pilot, a confirmation email will be sent fix}m a mission 

coordinator with a report containing all pertinent contact information for the patient and/or 

passengers. You will also be added into the Mission Coordination System "AFIDS" as the 

Mission Pilot for the leg ofthe mission you have chosen to fly. You can look up any scheduled 

pending missions by logging into AFIDS by using your usemame and password. Click on the 

link to "Mission Summary". 

Here is a suggested checklist for you to review after being assigned a mission. 

1. Introduction and verify/exchange phone/cell numbers and e-mail addresses. 

Make sure you have the patients contact number with you on the day of the mission. 

2. Verify departure time/appointment time and date. Confirm the time they need to 

be at their destination. 

3. Inquire about passengers flying and/or general aviation experience 

4. Inquire about special needs (oxygen, wheelchair, etc.) 

5. Verify weight, companions' weight, and remind passengers of baggage 

weight/size limits 

6. Discuss meeting time and place, FBO telephone number, address, etc. If needed, 

discuss alternate airports- possible cancellations 

7. Remind passengers of Waiver requirement 

8. Set FUght expectations (ETE, weather, etc) 

9. Inform PALS office of ANY changes or additions to information. If there 

are ANY last minute changes to any part of the mission, including number of 

passengers, weights, luggage, departure/arrival times, etc, please notify the office 

immediately. Even if you and your aircraft can handle the changes, the return pilot or 

linking pilot might not be able to. 

idl ^ 
PALS Pilot in Command Checklist 

The following is a suggested checkHst that could be used for every mission. 

Mission Preparation 

Prior to departure the pilot in command is responsible for: 

• Calling the mission coordinator with any changes you make that affect the 

mission 

• Calling the patient the night before the flight to reconfum meeting arrangements, 

verify who the other passengers will be (if any) and confirm the weights of all 

passengers plus baggage 

• Not flying anyone who is not listed on the Mission Report without first 

contacting a mission coordinator. PALS must be notified immediately, because an 

increase in the number (and weight) of passengers could affect the retum flight and the 

ground transportation 

• Calling the link pilots (if any) to reconfirm plans for the flight 

• Preparing a weight and balance calculation 

• Preparing a stamped envelope addressed to PALS 

• Obtaining a complete weather briefing, including 

NOTAMs, PIREPs and TFRs 

• Filing a flight plan using "CMF" identifier. See ''Use 

of 'CMF' (Compassion Flight) Call Sign" below, and the link 

on the Pilot page ofthe website for more information 

• Obtaining signed waivers of liability (and a guardian 

authorization if the patient is a minor) for all passengers who 

are not members of PALS (this includes copilots) 

• Mailing the signed waivers of liability, guardian 

authorization and weight and balance calculation from the 

FBO. Do not take these documents with you in the airplane 

• Taking photos of pilot(s), patient and other passengers 

• Securing all cargo to prevent it from coming loose in flight 

-14-
Notes: 

1. A single weight and balance calculation is acceptable for round trip missions 

when both flights occur the same day and carry the same passengers 

2. A flight plan must be filed for all PALS FLIGHTS carrying passengers. An IFR 

flight plan is strongly suggested. However, a VFR flight plan is acceptable if VFR 

conditions are forecast to exist along the entire route from one hour before departure to 

two hours after scheduled arrival 

3. One liability release or guardian authorization from each passenger is acceptable 

for round trip missions when both flights occur the same day and carry the same 

passengers 

Day of Flight 

1. Weather conditions, more precise flight time 

2. Ffle FUght Plans 

3. Contact Passenger, verify their condition for flight, and communicate current 

weather conditions and revised ETE. 

Passenger Pick up 

Since many passengers may be nervous flyers, even those that have flown many times, the 

more '^professional" and experienced the Pilot in Command looks, the more likely the 

passenger is to be comfortable. There are a few things that you can do to help ensure their 

mental comfort. First, dress professionally and ensure that the aircraft is clean and the interior 

uncluttered. Second, arrive early and be waiting when the passenger arrives. Next, greet them 

in a friendly and professional way and complete the paperwork in a professional manner. 

Allow enough time from the scheduled meeting time until flie fUght is to depart so that the prefUght time is unhurried. Plan to depart at a scheduled time and meet that schedule. 

1. Have them sign the Waiver 

2. Hand out PALS material/boarding form 

3* Obtain pictures if desirable 

4, Escort them to the aircraft after a short briefing about ramp safety 

5, Complete a thorough preflight briefing 

GA Aircraft/passenger intro - if necessary 

Weather 

Particulars of this mission (Forecast weather, ETE, ete) 

What is expected or desired of them - (sterile cockpit/en route) 

What to do if they have problems or issues 

6, Open IFRATFR flight plan and/or use FUght Following 

A ^ 
Passenger Drop Off 

1. Assist them in deplaning if necessary 

2. Ensure that all of their belongings have been removed from the aircraft 

3. Escort them off the ramp and to their transportation if necessary 

4. Confirm transportation is available 

5. If you are also providing their return flight, verify time, place, ete 

6. Con:^)Iete the Post Mission Report Form 

Airplane - Suggested items to be carried 

1. Headsets 

2. Camera 

3. Boarding Stool 

4. Passenger Comfort 

5. Relief packages/bottle(s) 

6. Air sickness bags 

7. Blankets 

8. Headsets/non-aviation 

9. PALS information handout 

10. Water or other refreshment 

j d ^ 
Linked Missions 

When we receive request for distances that require 

more than one flight, we call this a Linked Mission. 

The mission coordinator will oftentimes attempt to 

partition the mission into two — or even three — legs 

of approximately equal length. This allows two or 

more pilots to share in a single mission. 

While good preflight communications is important for 

every PAL Flight, it is critical for link missions. It is 

vital that all the pilots involved know that the mission 

is a "go" before they depart, and exactly where the 

patient transfer will occur at the link airport(s). 

Therefore, as soon as a pilot accepts a leg of a link 

mission he or she should contact the other linking pilot 

or pilots. They should be contacted again on the day of 

the mission just prior to the first aircraft's departure 

from the originating airport to verify that everyone 

involved is in agreement about how the mission will be 

conducted. 

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Use of "Compassion Flight" Identifier and Call Sign 

"Compassion Flight" and the three-letter identifier "CMF" were assigned in as an International Civil 

Aviation Organization (ICAO) Radiotelephony Designator and Three Letter Identifier, respectively. 

These two designations can be used to identify aircraft conducting bona fide, non-profit PALS missions. 

They are approved for both domestic and international fUghts. 

"PALS Flight" and "CMF" are not to be used during a positioning or ferry leg of a flight when patients, 

supplies, or emergency personnel are not being transported unless such a flight leg has time constraints 

such that there might be a need for helpful (but not priority) handling by ATC. "Compassion Flight" and 

"CMF" also cannot be used for routine personal, business or commercial flights. 

Filing a Flight Plmi 

Pilots filing a flight plan for a PALS flight should follow normal flight plan procedures, except for the 

following differences: 

1. In the block used for the aircraft registration (tail) number, the pilot shall enter the ICAO ThreeLetter Identifier CMF followed by three additional characters or numbers, consisting ofthe fmal 

three characters ofthe actual tail number ofthe aircraft to be used. 

2. An exception to the above applies if it is known that another aircraft using the same last three 

characters in its tail number might be flying in the same area. In this case the last four characters 

would be used in order to avoid confusion. (The block can hold a maximum of seven characters.) 

a. For example, if an aircraft's actual tail number is N-1234M, in the AIRCRAFT 

IDENTIFICATION block enter CMF34M; do not use the incorrect, overlong entry of 

CMF1234M. 

b. In the REMARKS block, the pilot should enter, separated by spaces, the words 

Compassion, followed by the full registration number (i.e., tail number) ofthe aircraft, 

followed by PALS. 

Example: Compassion N1234M PALS 

Note: ATC closes out flight plans by tail 

number, not by call sign. 

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Use of "Lifeguard'^ Identifier and Call Sign 

If there is ever a situation where the medical condition ofthe patient being flown by a PALS pilot should 

deteriorate during the flight, or other conditions occur that justify expeditious handling on a priority basis, 

then changing to the use ofthe "Lifeguard" call sign in place of "Compassion Flight" may be appropriate. 

ATC can assist a pilot in making that decision. Do not hesitate to use "Lifeguard" if safety or medical 

necessity warrants its use. 

The "Lifeguard" call sign should also be used when an organ transplant patient or donor organ is on board 

or if it is necessary to minimize the flight time required to reach an airport for an organ pickup. 

Air Traffic Control will expedite the handling of aircraft using a Ufeguard prefix to their fUght identifier. 

This could result in other aircraft being diverted and possibly great disruption of operations being 

conducted by other users. It is intended for use only when expeditious flight handling is required, 

CanceUations, Changes and Delays 

Pilots are free to decline to fly any assigned flight, whether for weather, mechanical problems, financial 

limitations, scheduling confUcts or personal reasons. Safety is the primary concem. Pilots are 

encouraged to set their own personal minimums and recognize tiieir limits. They should fly only when 

they feel completely comfortable doing so. A pilot's decision to depart on schedule, delay the fUght or 

cancel it is final. 

Should it become necessary to cancel an assigned flight, it is very important that the pilot notify both 

PALS Mission Coordination and the patient as soon as possible. The more time PALS has to determine if 

another pilot can fly the mission, the better. It will also allow PALS flight time to handle other issues 

related to the mission, such as ground transportation. Notifying the patient as soon as possible will 

maximize the time available to him or her to make other travel arrangements, should that become 

necessary. 

It is also necessary to notify PALS and the patient as soon as possible if there is a chance or delay in the 

flight times or a change in an FBO that will be used. 

Cancellation, changes and delays affecting assigned flights can be communicated to PALS by calling the 

main phone number @ 888-818-1231 or 516-300-1660, during normal business hours (8:30a.m. to 

4:30p.m. Monday through Friday). 

Outside normal business hours, call PALS at 1-888-818-1231 and you will be automatically forwarded to 

the Mission Coordinator on-call. 

Some additional phone numbers to keep in an emerpencv are: 

Eileen Minogue - Director of Operations 516-640-1391 

Karen Krolikowski 516-640-1390 

- Mission Coordination Manager 

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Do NOT US9 ontall 

to notify PALS o f 

flight cmncollatlons, 

changos or dolays 

p^ 
Crisis and Risk Management 

The purpose of this communication is to: 

1. Provide all volunteers with guidelines on the nature of a 

crisis and how it could affect PALS. 

2. Provide volunteers with a set of recommended action steps 

and contact numbers in the event of an emergency or crisis while 

on a PALS mission. 

What is the potential impact on PALS? 

The mismanagement of information or any miscommunication related to a 

crisis could lead to serious consequences for PALS. These risks include: 

• Investigations 

• Lawsuits 

• Negative publicity 

• Trauma to patients, passengers or volunteers 

• Potential shutdown of PALS operations 

In order to minimize such risks it is essential that a standard approach be 

adopted in the event of a crisis. 

Definitions: 

Crisis: An event that could have a tremendous negative effect on our organization in the press, in the courts, 

in the eyes ofthe general pubUc and in the opinion of regulators and other public officials. 

Accident: An occurrence associated with the operation of an aircraft or vehicle, which takes place between 

the time any person boards the aircraft or vehicle with the intention of fUght or transportation and all such 

persons have disembarked, and in which any person suffers serious injury or death, or in which the aircraft 

or vehicle receives substantial damage. 

Incident: is an occurrence that may not necessarily rise to the severity of an accident. 

Serious Injury: is an injury requiring hospitalization. 

Substantial Damage: Substantial damage is damage which adversely affects the operational capabiHty of an 

aircraft or vehicle in PALS service. 

Crisis & Risk Management Dos and Don'ts? 

Do make patient care and comfort # 1 priority 

Do Contact PALS headquarters immediately 

Do refer all queries to PALS headquarters 

Do cooperate with FAA/NTSB authorities 

Do state only facts to proper authorities 

Do contact your insurance company 

However... 

Do NOT give media interviews 

Do NOT speculate on cause ofthe event 

Do NOT apologize or admit liability 

-20-
Mission Photos 

Pilots are requested to provide photos to PALS of the pilot, patient and other passengers the first time a 

particular patient is being transported by the pilot in command, if appropriate, and if the patient and other 

passengers agree to have their photos taken. The preference is for one photo inside the aircraft showing 

only the patient and passengers, and one outside photo ofthe pilot(s), patient and passenger(s). 

The photos are best taken with a digital camera using jpeg format. They can be sent to PALS as 

attachments to an email. The email should include the mission number and the names ofthe pilot(s), patient 

and other passengers. 

At the bottom ofthe liability release is a place for the patient and other passengers to initial (or the patient's 

guardian to initial, in the case of a guardian authorization). This permission allows PALS to use the 

patient's and other passengers' names and/or photographs for public relations purposes. If the patient and 

other passengers (or guardian, in the case of a minor) do not initial this permission request, their names and 

photographs will not be used. 

You may also wish to provide copies of the photos to the patient, either as hard copies or as jpeg files Emailed to them. Many patients like having photos as souvenirs of their PALS flights, and enjoy sharing 

them with family and friends. 

Fee Waivers and Fuel Discounts 

Many, but not all - airports waive landing and parking fees for PALS fUghts. Many FBOs also give fiiel 

discounts for PALS flights. You should always ask. 

It may prove helpfiil to have the Post Mission Report in hand when requesting fee waivers and/or fuel 

discounts. Wearing your PALS FUght photo ID badge may also prove helpful. In addition, being clearly 

identified as a PALS flight pilot may make you eligible for other discoimts and/or waivers. 

-21-
L 

Post-Mission Procedures 

The pilot in command is requested to file a Post Mission Report (PMR) online within 48 hours upon 

completion of your mission. Filling in your mission reports online helps to streamline the process for the 

mission coordination team, saves you time and aUows us to provide more accurate information at the end of 

the year for your taxes. 

The data from the mission record is pulled into the mission report form, so often times you only need to add 

your Hobbs time. By tracking the total time you fly for PALS fix)m your home base back to home base, we 

will be able to more accurately reflect your service donation in our records and yours. 

To fill in you mission report online: 

• Login to AFIDS 

• CUck on the link "File Mission Report' located on the left-hand blue column ofthe screen. All of 

your mission legs for which there are outstanding mission reports are Usted for you. 

• Check a mission leg and then click "submit" to fill out the mission report form for that mission leg. 

Repeat this process for each ofthe mission legs you have flown. The system provides a confirmation page 

that you can ^smi for your records. You will also have access to a statement year round as well as the end of 

the year showing the hours you have flown for PALS. 

• If you mission was canceUed, do NOT fill out a mission report. Please notify the Mission 

Coordinator immediately by calling 1888-818-1231, so the system can be corrected. If the mission appears in 

your list, the Missions Team is not aware that the mission has been cancelled. This is very important to keep 

our monthly mission and financial reporting accurate. 

• Enter the Hobbs time for the whole trip (home base to home base), not just the flight segments where 

the passenger was on board. The total time in air is being tracked for PALS. 

• Sometimes several mission legs are completed in a single fUght. For example, you may have more 

than one passenger going from the same origin to the same destination, or a three-legged flight with more 

than one passenger. You may group these mission legs into one mission report by checking each ofthe 

mission legs that were a part of that flight. Enter the Hobbs time for the trip. 

• For example, two passengers, Bill and Mary, go fiom SMO to SMA and the round trip is 1.8 hours. 

Check the box next to the mission leg for Bill AND the mission leg for Mary. In the Hobbs time field, enter 

1.8. 

Only group mission legs when they were part of the same flight. Do not group mission legs that took 

place on different days. 

• Sometimes the date ofthe mission changes. For example, you may delay a flight due to weather to the 

next morning. Enter the new date in the mission report form. The listing will continue to show the scheduled 

date, but other reports used internally will reflect the correct date. 

-22-
Mission Photos 

Mission photos in jpeg format should be sent as email attachments to PALS at www.palservices.org. Be 

sure to include the names ofthe pilot, patient and passengers, the date ofthe fUght and the mission number. 

Mfapion CommgntflrY 

Patient AirLift Services continually strives to improve the PALS FUght experience for patients, passengers 

and pilots. Pilots are encouraged to aid in this process with: 

• Comments on how future flights could be made better for patients and passengers. 

• Suggestions on how the interaction between pilots and mission coordinators could be improved. 

• Information on any significant physical, medical or behavior problems with the patient that could 

affect future fUghts with that patient. 

• Heartwarming, interesting or humorous anecdotes, especially those that would be suitable for use in 

public relations activities. 

• Any other information that the pUot feels is relevant. 

Please note any ofthe above on your Post Mission Report in the comments section. 

L -23-
Piiot Checklist of Dos and Don'ts 

Do 

Contact patient early and 

Prio r t o Missio n as often as necessary 

Confirm patient and 

passenger data and inform 

mission coordinator of any 

changes 

Choose and use optimal 

airports and FBO's 

Use handbook dunng 

missions as a reference 

File a flight ptan using the 

"CMF" Identifier 

Don't 

Change any mission 

particulars without informing 

mission coordination 

Misuse or abuse your 

Compassion Flight Status 

Relegate your responsibilities 

as Pilot in Command 

Mail or Fax completed 

weight and balance data 

Prio r t o Departur e and waiver forms 

Accept undocumented 

passengers or baggage 

Provide for needs of the 

Durin g th e Missio n patient and passengers 

Keep passengers informed 

of flight progress 

Comply with all applicable 

regulations and insurance 

requirements 

Compromise Safety 

Exceed aircraft's or your own 

limitations 

Unnecessarily maneuver or 

communicate in any way that 

might unduly concern your 

passengers 

After the Mission 

File Post Mission Report 

online within 48 hours after 

mission completion 

Maintain currency and 

proficiency 

Ensure PALS records are 

current and complete 

Update and commit to 

personal mtntmums 

Make separate arrangements 

with patients regarding 

scheduling future flights 

Forget to review this list 

-24-
Attachments 

L -25-
Pilot Application Checklist 

This checklist should be used as a tool to help avoid delays in processing your 

application. Please make certain that ALL ofthe following is forwarded on to 

Patient AirLift Services after you have completed your online application. 

1. Signed copy ofthe Pilot Affirmation 

2. Copies ofthe last few pages of logbook showing total hours 

3. Photocopy of Current FAA Pilot License 

4. Photocopy of Current Medical Certificate 

5. A copy of your latest BFR (or check ride) fi-om your log book 

6. A copy of your latest IPC (if applicable) from your log book 

7. Photocopy ofthe declaration page of your current aircraft insurance 

policy (you do not need to name us additionally insured) 

8. Please give us your size for 

Shirt Med L XL XXL: 

9. Please email a current digital photo of yourself (passport type 

headshot desired for I.D. badge) to 

eileen.minogLie(?f.jpalservices.orfl 

10. Please mail all of the above to: 

Patient AirLift Services 

120 Adams Boulevard 

Farmingdale, NY 11735 

or fax to: 631-755-2184 

Please note: All photocopies and/or scans must be readable 

-26-
-BPatient AirLift Services 

,[-'.lii=t:i».^l.)rjnd.i'iT'i41i 

SHW ^ 

\ If yo u alread y hav e a password : 

Usemame 

Password 

User Login 

Porgr. t y oi/r PSSSW'-ird^ 

Off rf yo u ar e a member : 

Member ID 

Last Name 

Zip Code 

Member Login 

Or^ logi n a s ou r guest : 

Guest Login 

L -27-
-cPatlent AirLift Services 

24-hour Hotline: 888-818-1231 Office: 888-818-1231 Fax: 631-755-2184 

Mission # : 1015 Missio n Itinerar y Date: 05/14/2010 

Primary Coordinator: 

MISSION DATE: 05/17/2010 Appointment Oate/Tlme: 11 am (need 

PATIENT INFO 

Name: :)ack Smith (Male) 

DOB/Age: () 

Weight: 200 

Contact: 

Prim. Phone: 

Illness: 

Lodging: 

Destination: 

Social Wkr: Passenger Requester-USE THIS ONE 

Passenger Requestor 

Address: 123 main 

anytown, NY 

Language: 

Bast Contact: 

Other: Email: dd@creative.cDm 

Treating 

Physician: 

Releasing 

Ptiysician: 

Phone: 

Leg 1 : Patient AirLift Services — 888-818-123 1 

FROM: MMU(ET) GMT -5 

->ETD : 

TO: BOS(ET) GMT -5 

->ETA: 

Pilot: Alan Pilot 

->Alrcraft : C182 

Airport Name: Morristown Muni City/St: Morristown, NJ 

FBO: FBO Phone: 

Airiwrt Name: General Edward Cfty/St: Boston, MA 

Lawrence Logan 

FBO: FBO Phone: 

Phone: Work: (973) 974-xxxx Home: (908) 955-xxxx Fax: (973) 974-xxxx 

Cetll: (949) 289-xxxx Email: xxxxe5sam@yahoo.com Secondary Email: 

alan.p1lot@palserv)ces.org 

N Number: N-xxxx Ice: No 

COMPANIONS AND MISSION WEIGHT 

Companion name Relationship DOB Weight 

Baggage: normal 25 

Total Mission Weight (passenger, com|>anlon(s), baggage): 225 

Phone 

-28-
-DPatient AirLift Seivices 

![i,\^iM:i#.M.I*:iC'1'.nT4:f1 

Return to the Mission Sumniary 

-29-