Please fill out the form below and describe your wish are clearly as possible, stating the address where you would like to be picked up from and the address/destination you would like to go to. We will then look into the organisational aspects of your wish and will contact you as soon as possible. For us to do this please provide all relevant telephone numbers on which we can reach you as well as an email address.
The Ambulance Wish Foundation UK fulfils all wishes for free. However, if you could include a brief account of your wish and the reasons behind it we would like to share your story anonymously with our sponsors and to generate more donations for the foundation in order to help others fulfil their wishes too.
By completing the form you consent to the information being shared to our carefully selected and trained volunteers. The information you provide will be kept securely and in accordance with current GDPR requirements.
Please read this section carefully prior to completing the application form. If you have any problems completing the form, please contact us by email on firstname.lastname@example.org. One of our team will respond.
Users must have the support of their lead clinician in undertaking the proposed journey. The lead clinician must be named on the application and they or their deputy need to be contactable (if required) for the duration of the wish.
Users must have enough and appropriate medicines and medical devices for the proposed journey and an escort authorised to administer such medicines and maintain any devices. We can carry medications securely for the duration of the wish.
In the event of an emergency, the policy of the charity will be to halt the transport in a safe place and dial 999 to request the attendance of an NHS emergency ambulance.
Due to the Deregulation Act 2015, we cannot provide emergency transport to a hospital using blue lights and sirens. Whilst awaiting the attendance of an emergency ambulance AWF-UK volunteers can provide basic first aid only.
In the event of the service user’s condition deteriorating during transport, the AWF-UK volunteers can provide basic first aid only.
The journey will be aborted and the Wish user will be returned to the original pick-up address.
All persons must carry with them a valid Do Not Resuscitate order (DNA-CPR) and/or a valid Advanced Directive to Refuse Treatment (ADRT), which states that resuscitation is not wanted or have a person travelling with them with a valid Power of Attorney - Health & Welfare (LPA-Health & Welfare) and who has signed the attached disclaimer.
By completing and returning this application form you accept the above conditions. For further information on the terms used, please discuss with your Palliative Care Providers or check out the following websites: