Request a Mission

Mission Request Information

The information that we gather is never sold or disseminated in any form.  This form is for internal use by Houston Ground Angels (HGA).  Information is used to create demographics which will enable HGA to make applications for grants from corporations, foundations, and philanthropic organizations.

 Houston Ground Angels Ground Transportation Request Form

 (To provide you with the best opportunity for a ride, a 48 Hour Advance Notice Is Requested.)


Required Fields

Arrival Information


Departure Information


Patient Information

 *By checking this box I agree to the liability release document for both adult and child. As found in this link

If you have any question please contact us at the email below :
HGA Mission Coordinator
Kathy Cardiff