Priority handling for HOSP and AIR EVAC aircraft is provided only when it is:

Priority handling for HOSP and AIR EVAC aircraft is provided when it is specifically requested by the pilot. This requirement emphasizes the importance of clear communication and active engagement from the pilot to relay the need for priority, ensuring that air traffic control and other necessary parties are aware of the urgent nature of the situation.

A request from the pilot acts as a formal notification that priority handling should be in effect, allowing air traffic personnel to prioritize their approach and landing to accommodate medical emergencies or critical needs associated with these types of flights. This process underscores the protocol that not only requires clear understanding among aviation professionals but also maintains the necessary safety and logistical measures in air traffic management.

In contrast, the other options—such as making an announcement, assuming priority automatically, or requiring something in writing—lack the immediacy and efficiency that come from a direct request from the pilot, which is critical in time-sensitive scenarios often associated with hospital and emergency evacuation flights.