Get Medif Alitalia

Filling out the Medif Alitalia form is a crucial step for travelers requiring medical assessment before air travel. This guide provides a clear and structured approach to ensure all necessary information is accurately submitted.

Follow the steps to complete the Medif Alitalia form online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Enter the customer's name, initials, sex, and age in the designated fields. Utilize block letters or a typewriter for clarity.
3. Provide the attending physician's name and address, along with contact telephone numbers, including mobile and home.
4. Detail the medical data required, including the diagnosis, vital signs, and dates for the first symptoms, operation, and diagnosis.
5. Indicate the prognosis for the flight. This section helps assess the customer's fitness to travel.
6. Answer whether the customer has a contagious or communicable disease by marking 'YES' or 'NO.' If 'YES,' specify the condition.
7. Confirm if the customer requires special assistance. Indicate this by selecting 'YES' or 'NO' and provide details if applicable.
8. Determine if the customer can use a normal aircraft seat in an upright position, marking the appropriate box and specifying if needed.
9. Assess whether the customer can care for their own needs on board unassisted and specify if any type of escort is proposed.
10. Check if the arrangements for being escorted are satisfactory as indicated in previous sections.
11. Indicate if the customer needs extra oxygen equipment in flight and specify the flow rate.
12. State if the customer requires medication other than self-administered, and detail any special apparatus needed.
13. Confirm if hospitalization is necessary upon arrival or during transit, indicating arrangements made or specifying 'No Action Taken.'
14. Provide any additional remarks or information that may aid in ensuring the customer's smooth and comfortable transportation.
15. Conclude by ensuring the attending physician signs and dates the form, adding their stamp if necessary.
16. Finally, the customer must authorize their physician to share health information by signing and dating the designated section.

Complete your Medif Alitalia form online today to ensure a smooth travel experience.