Medif Form Qatar Airways – Fill Out and Use This PDF

The Medif Qatar Airways form, or MEDICAL INFORMATION FORM (MEDIF), is a critical document designed to ensure the wellbeing and safety of passengers requiring medical attention during their flight. It comprises two sections: one to be filled out by the airline's sales office or agent, and the other by the attending physician to provide comprehensive medical information. If you or someone you care about requires special medical assistance while flying, completing this form is a crucial step in the preparation process. Click the button below to start filling out the form and ensure a safe and comfortable journey.

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Medif Form Qatar Airways PDF Details

Traveling with certain medical conditions requires thorough preparation and clear communication with the airline, a fact underlined by the structure and content of the Medical Information Form (MEDIF) required by Qatar Airways. This form, an essential document, serves multiple purposes, including ensuring the safety of passengers with health issues during flights and facilitating necessary accommodations. The MEDIF form is divided into two main sections; the first part is completed by the sales office or booking agent, capturing basic passenger information and proposed itinerary details. The second, more critical part requires comprehensive medical information provided by the passenger's attending physician. This includes diagnosis, prognosis, and specific needs such as oxygen tanks, stretchers, or medication during the flight. Additionally, it confirms the passenger's ability to care for themselves or their requirement for special assistance. The completion of this form, which must be submitted prior to travel, activates a process within the airline to ensure all necessary preparations are in place, emphasizing the form's role not just in communication, but in passenger safety and comfort. Through stipulations regarding confidentiality and the relieving of the physician's duty of confidentiality, the form balances the need for medical transparency with respect for patient privacy. Furthermore, the conditional authorization for onboard and pre-flight medical requirements illustrates a comprehensive approach to passenger health. Ultimately, the MEDIF form showcases the airline's commitment to accommodating passengers with health considerations, ensuring they can travel with dignity and in safety.

Question	Answer
Form Name	Medif Form Qatar Airways
Form Length	1 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	15 sec
Other names	qatar airways health form, qatar fit to fly, qatar airways medif form, qatar medical form

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MEDICAL INFORMATION FORM

(MEDIF)

PART I:

To be accomplished by Sales Office/Agent

PLEASE COMPLETE THE FORM IN BLOCK LETTERS

Airlines’

Name of Passenger:

Sex:

Age:

Weight:

Height:

Ref. code

MEDA 1

MEDA 2

Address:

Contact No(s):

ROUTING

CARRIER

FLT. NO.

CLASS

DATE

BOOKING REF.

PROPOSED

ITINERARY

MEDA 3

NATURE OF PHYSICAL CONDITION:

DEAF/MUTE

OTHERS:

PART II: MEDICAL INFORMATION (To be completed by ATTENDING PHYSICIAN prior to submission to PAL Medical for clearance)

(Where needed, to be read by/to passenger, dated and signed by him/her, or on his/her behalf).

“I HEREBY AUTHORIZE ___________________________________________________to provide the airlines with the information required by the

(Name of Nominated Physician)

airlines’ medical department for the purpose of determining my fitness for carriage by air and in consideration thereof I hereby relieve that physician of his/her professional duty of confidentiality in respect of such information, and agree to meet such physician’s fee in connection therewith.

I take note that, if accepted for carriage, my journey will be subject to the general conditions for carriage/tariffs of the carrier concerned and the carrier does not assume any special liability exceeding those conditions/tariffs.

I agree to reimburse the carrier upon demand for any special expenditures or costs in connection with my carriage.”

Passenger’s Signature:

Place:

Date:

Information written in this form shall be CONFIDENTIAL.

FOR PAL PHYSICIAN’S USE ONLY

The PHYSICIAN ATTENDING to the incapacitated passenger is requested to ANSWER

ALL QUESTIONS (Enter a cross “X” in the appropriate “yes” or “no” box and/or

DATE:____________________

give precise answers).

Clearance for air travel DENIED

IMPORTANT:

(**)Fees, if any, relevant to the provision of the information below, including but not limited

Okay for BOOKING; To report to PAL Medical Clinic

to OXYGEN BOTTLES, STRETCHER and/or AMBULANCE are to be paid by the

4 hours before check-in time.

passenger concerned.

NOTE:

CLEARED for air travel until_______________

(*)Cabin Attendants are NOT authorized to give special assistance to a particular

passenger to the detriment of their services to other passengers. Additionally, they are

trained only to render FIRST AID and are NOT PERMITTED to administer any injection

_____________________________________________

or to give any medication.

PRINTED NAME & SIGNATURE OF PAL PHYSICIAN

Name:

MEDA 4

ATTENDING PHYSICIAN

Contact Nos.

Business:

Home:

MEDICAL DATA

Date of Diagnosis:

MEDA 5

Diagnosis in detail:

> ILLNESS:

___________

(including vital signs)

> SURGERY: ___________

> INJURY :

___________

Wheelchair category : WCHR

WHEELCHAIR needed?

YES

Collapsible?

YES

Own wheelchair?

YES

WCHC

MEDA 6

Battery type, spillable?

YES

Power driven?

YES

WCHS

Wheelchairs with spillable batteries are “dangerous goods” and are permitted on passenger aircraft only under certain conditions,

which can be obtained from the airline(s). In addition, certain countries may impose specific restrictions

MEDA 7

Is STRETCHER needed on board the aircraft? **

YES

If YES, type of escort required:

Liters per

Type of escort required:

MEDA 8

Does patient need OXYGEN on board? **

YES

minute:

Continuous?

YES

No. of OXYGEN

tanks reqd:

MEDA 9

PROGNOSIS for the trip:

GOOD

FAIR

POOR/GUARDED

MEDA 10

Contagious/communicable disease?

YES

Specify:

MEDA 11

Is patient’s condition likely to be a source of discomfort

YES

Specify:

to other passengers? (Odor, appearance, conduct)

MEDA 12

Can patient use normal aircraft seat with seatback placed

YES

Remarks:

in UPRIGHT position when required?

MEDA 13

Can patient take care of his own needs on board UNASSISTED

YES

If YES, type of help needed:

( including meals, visit to the toilet, etc.)?

Does patient need any MEDICATION* other than self-administered

A) on the GROUND while at the airport(s):

MEDA 14

YES

Specify:

and/or the use of special apparatus such as respirator, incubator, etc.**?

B) aboard the AIRCRAFT:

MEDA 15

(Clearance with PAL Safety & Environment Department required)

YES

Specify:

MEDA 16

A) during long layover or nightstop at CONNECTING POINTS en route?

Does patient need HOSPITALIZATION?

YES

Action:

(If YES, indicate arrangements made or,

B) upon arrival at DESTINATION:

if NONE were made, indicate “NO ACTION TAKEN”)

MEDA 17

YES

Action:

MEDA 18

Other remarks or information in the interest of your

NONE

YES

Specify:

patient’s smooth and comfortable transportation?

MEDA 19

Ambulance**

NAME OF AMBULANCE:

PLATE NO.:

NAME OF DRIVER:

requirement: NO

YES

MEDA 20

Name of companion/paramedic onboard ambulance:

Attending Physician’s Signature:

Place:

Date:

Copy Distribution: 1 - Origin Stn. (WHITE)

2 - Boarding Stn.(BLUE) 3 - Destination Stn. (PINK)c/o Purser 4 - Attending Physician (GREEN)

5 - Passenger (WHITE)

Medif Form Qatar Airways – Fill Out and Use This PDF

Medif Form Qatar Airways PDF Details

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