9 LINE MEDIVAC|F!703

! 9 Line Medivac Reporting Form
!! Form Version: 10/28/2025 - WW9Y
# Form published 10/28/2025 by WW9Y

[LO] LOCATION:
[RA] RADIO FREQ and CALL SIGN:

? Patients by Precedence? 
@1 URGENT
@2 PRIORITY
@3 ROUTINE
@4 CONVENIENCE

? Special Equipment?
@1 HOIST
@2 EXTRICATION
@3 VENTILATOR
@4 INCUBATOR
@5 NONE 

? Total Patients?
@1 LITTER
@2 AMBULATORY

? Security at Pickup? 
@1 NO ENEMY
@2 ENEMY IN AREA
@3 POSSIBLE ENEMY
@4 EVACUATE UNDER FIRE

? Marking Method? 
@1 PANELS
@2 SMOKE
@3 FLARE
@4 LIGHT

? Patient Nationality/Status? 
@1 US MIL
@2 US CIVILIAN
@3 NON US MIL
@4 NON US CIV
@5 EPW

? NBC Contamination/Terrain/Remarks? 
@1 NONE
@2 BIOLOGICAL
@3 CHEMICAL
@4 RADIOLOGICAL
@E NUCLEAR