Request A Flight

Our team is here for you and your family by providing much needed travel assistance in times of need.

Please complete the questions below to help us gather the information we need about the Hero and the passengers who will be traveling. Our team has a quick turnaround for emergency situations. However, if time allows, we request a two week notice before your desired travel date.

To request travel, please review the eligibility requirements and complete the application below. We are honored to serve our military community and support you however we can!

If you have any questions throughout the application process or determining if you are eligible to apply, please do not hesitate to contact our team by calling (512) 971-9848.

Request Travel New

Step 1 of 5 - New Request

Date of Request*
MM slash DD slash YYYY
Are you traveling to reunite with a wounded, ill, or injured Service Member, Veteran or First Responder?*
- Yes
- No
Was the Service Member, Veteran, or First Responder to which you’re traveling injured or became ill, in the line of duty?*
- Yes
- No
Explain the circumstances or incident that caused the injury/illness.*
Questions? Reach out to Shannon ([email protected]) if you have any difficulty filling out this form.

Service Member, Veteran, or First Responder Information:
Please let us know about the Hero requesting assistance, and a little about their service.
Service Member Name*
First Last
Date of Birth*
What is the Service Member's DOB?
Gender*
What is the service member's gender?
Race*
What is the service member's race?
Branch of Service*
Please provide the Service Member's branch of service.
Rank
Service Member's Current Military Status*
Please provide the Service Member's current status.
Duty Location (if active duty):
Phone
Email
Questions? Reach out to Shannon ([email protected].org) if you have any difficulty filling out this form.

Validation of Medical Treatment
As part of the approval process, Luke's Wings requires verification of treatment.
Current Treatment Facility
Does the Service Member, Veteran or First Responder require a Non-Medical Attendant (NMA) per the direction of a medical professional?*
- Yes
- No
Current Medical Provider/Medical Case Manager Name*
Prefix First Last Suffix
This should be a healthcare professional who is able to confirm the status of treatment for the Service Member.
Current Medical Provider/Medical Case Manager Title
Current Medical Provider/Medical Case Manager Phone Number*
Current Medical Provider/Medical Case Manager Email
Medical Diagnosis of Injury/Illness (Attach proof of service-connection)*
Max. file size: 128 MB.
Describe Recovery Program:*
Questions? Reach out to Shannon ([email protected]) if you have any difficulty filling out this form.

Passenger Information:
For verification purposes, please provide the passenger's full name as shown on license or other appropriate legal documentation.
Number of Passengers:*
Name*
First Last
Hidden
Relation to Service Member, Veteran, or First Responder*
Date of Birth:*
Gender:
Email:*
Phone:
Known Traveler Number (if applicable):
Date of Travel*
Departure Airport:*
Arrival Airport:*
Specific Travel Accommodations (if applicable):
Questions? Reach out to Shannon ([email protected]) if you have any difficulty filling out this form.

CAPTCHA
Date
MM slash DD slash YYYY
Questions? Reach out to Shannon ([email protected]) if you have any difficulty filling out this form.
Name
This field is for validation purposes and should be left unchanged.

Request a Flight

Request A Flight

Our team is here for you and your family by providing much needed travel assistance in times of need.

Request Travel New

Step 1 of 5 - New Request

Service Member, Veteran, or First Responder Information:

Validation of Medical Treatment

Passenger Information:

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Request a Flight

Request A Flight

Our team is here for you and your family by providing much needed travel assistance in times of need.

Request Travel New

Step 1 of 5 - New Request

Service Member, Veteran, or First Responder Information:

Validation of Medical Treatment

Passenger Information:

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