How to Fill Out Form PS-05-29A

Form PS-05-29A at a glance

What it is: PREGNANCY CERTIFICATE, FORM PS-05-29A (901-1361) (Rev. 4/71): Original: Local file. Duplicate: Captain of flight. Triplicate: Passenger.

Who signs: "I certify that I have examined (1) on (2) and have found her physically able to travel by Air from (3) to (4) on (5) and that the estimated date of birth of the baby is (6) Date (7) Signed (8) Physician".

A filled-in Form PS-05-29A example: a physician certifies a passenger

Form PS-05-29A example filled out, example: a physician certifies a passenger
Dr. Alan Sample fills out a Pregnancy Certificate for passenger Mary Example. He examines her on 03-02-2026, and she flies on 03-20-2026 with a due date of 07-15-2026. He issues the certificate on the day of the examination. Anytown is where she starts and Sampleville is where she lands. The picture shows the form, and none of its entries is real.

How to fill out Form PS-05-29A, box by box

Passenger's name, dates, points and signature of physician

Form PS-05-29A example filled out, passenger's name, dates, points and signature of physician

Enter 1. Passenger's name, 2. Date of Examination, 3. Originating Point, 4. Destined Point, 5. Date of travel, 6. Date of birth estimated, 7. Date certificate issued, and 8. Signature of Physician.

Sources

[1] Form PS-05-29A (Rev. 4/71), Pregnancy Certificate (the Official source link on this page).

Pregnancy Fit To Fly Letter Sample Form PDF Details

Traveling during pregnancy requires careful planning, especially when it involves flying. Airlines have specific guidelines to ensure the safety and comfort of expecting mothers and the fetus during flights. A crucial part of this process is obtaining a Pregnancy Fit To Fly Letter, a document that acts as a green light for air travel from a healthcare professional. It certifies that a thorough examination has been conducted on the passenger, referencing their name, the date of examination, and crucial details about the flight, including originating and destined points, as well as the date of travel. Furthermore, it reassures airlines that the expecting mother’s estimated due date is considered, minimizing any risk to her and the baby during the flight. This letter, Form PS-05-29A, bearing the doctor's signature, must be issued close to the date of departure to ensure its validity. Its copies are distributed among the passenger, the flight's captain, and retained by the issuing physician, ensuring all parties are informed and supportive of the passenger's journey. Understanding the significance and the mandatory details required for this certificate can smoothen the experience for expecting mothers preparing for air travel.

QuestionAnswer
Form NamePregnancy Fit To Fly Letter Sample Form
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesindigo fit to fly certificate download for pregnancy, pregnancy indigo fit to fly certificate download, fit to fly certificate pregnancy format, fit to fly certificate format