Complete the web form below to apply for membership.
Membership Fees are $75 per household and cover all listed members of your immediate family so long as they remain residents in your household. Upon completion of the form below, you will be redirected to the Online Payment page for credit card payment via PayPal. You may also remit a PERSONAL or COMPANY CHECK to the address shown here.
As a member, if you receive a covered transport by Haynes Life Flight, Haynes Life Flight will accept the amount paid by your insurance carrier as payment in full. Therefore, you will not have any out-of-pocket expense. This can save you hundreds and sometimes thousands of dollars, since many insurance carriers do not cover the full cost of air ambulance services.