Medical Certificate Of Fitness For Air Travel printable pdf download

Medical Certificate Of Fitness For Air Travel

MEDICAL CERTIFICATE OF FITNESS FOR AIR TRAVEL

This Medical Certificate must be completed in full, and produced while booking and at check-in and while boarding at each

embarkation by any passenger who has a medical condition.

PATIENT INFORMATION

Name of Patient

Medical Condition

Nature of Treatment

Departure flight number and date

Return flight number and date

Contact number

MEDICAL PRACTITIONER’S DECLARATION

The patient is able to walk unaided.

Yes

The patient is able to sit upright unassisted.

Yes

The flying is not likely to cause the patient to require emergency medical attention.

Yes

The patient’s condition is not contagious/infectious.

Yes

The patient does not require oxygen support.

Yes

Travel Companion required.

Yes

Wheel chair required.

Yes

Note: If the passenger has an infectious, contagious or communicable disease, Spicejet may in its absolute discretion disallow

boarding in the best interest of the passengers and crew. In case of oxygen/ stretcher requirement please fill MEDA form.

Medical Practitioner’s Signature:

Registration Number

Contact Number

Stamp

Indemnity Bond by Passenger

I the undersigned _________________________________________ hereby indemnify the hold harmless SpiceJet from and

against any liability arising out of any bodily injury and / or death, damage or loss that may suffer/experience and also from any

damages, payments, expenses, face and cost which SpiceJet may incur directly as a result of accepting me on its Flight

No._________________ from _________________________ to _________________________ on ____________________

I hereby further indemnify SpiceJet for any payments that SpiceJet makes to meet any of my expenses towards damages, loss etc

for said purpose.

Signature: _____________________________________________________ (Passenger)

Address: ______________________________________________________________________________

(Temporary) ____________________________________________________________________________

____________________________________________________________________________

Tel. No. ______________________________________________________________________

Medical Certificate Of Fitness For Air Travel