Fillable Online medical information form for air travel Fax 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin with Part 1, entering your Record Locator number (PNR) and filling in your personal details such as full name, title, age, and gender. Ensure all entries are in capital letters using black ink.
3. Provide your proposed itinerary by specifying routing from and to, along with the flight number.
4. Detail any disabilities or medical conditions in section C. Include information about your intended escort if applicable, indicating their qualifications and ability to assist you.
5. In sections D through J, answer questions regarding wheelchair needs, ambulance requirements, hospital arrangements at the destination, and any specific in-flight requests.
6. Complete Part 2 by having your attending physician fill out their section. They will provide confidential medical information necessary for assessing your fitness to fly.

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