Medical Verification Statement

A medical verification statement is one that is provided by a certified medical professional for a patient who wishes to undertake air travel. The statement provides all the medical information of the passenger who is traveling and requires use of positive airway machine. The statement has to specify the type of use that the passenger requires including the duration and time specification such as takeoff and landing.

Apart from this the physician should provide all details about the patient that the airlines company is expected to know in order to act in situations of medical emergency that patient may face. Lastly the physician declares that the patient is competent to operate the airway machine or is accompanied by an attendant to operate the machine properly.

Sample Medical Verification Statement

Name of the passenger – Jonathan Sample

Address of the passenger – #4, Wallsend, Nottinghamshire, London, NG9

Contact number of passenger – 222-333-4444

Name of the Physician providing medical verification – Dr. James Coggan

I provide medical verification for the passenger traveling on your flight as under :-

  1. The passenger has the ability to understand and make use of the airway machine independently without any assistance from any one.
  2. The patient does not require any oxygen onboard including times of takeoff and landing.

Verification Statement:

I Dr. James Coggan bearing registration MD1234 certify that the above specified patient is under my care and advise and is fit to undertake air travel without any physical or health risk. My patient understands that he is solely responsible for the operation of the airway machine without any assistance and shall carry sufficient batteries fit for its operation. The patient has a physical condition that is stable for air travel and does not require any medical assistance in any way. I understand that any change in the condition of the patient would bring in a modification to the clauses specified by me here above and require a fresh physician’s medical verification statement.

Physician Signature            __________________________

Date                                   __________________________