Medical Information Form (MEDIF)
Customers planning to use medical oxygen cylinders or special medical equipment are required to provide a medical certificate(MEDIF).
- ■Customers requiring an Oxygen Cylinder
- ■Customers requiring Portable Oxygen Concentrator (POC) and/or other medical devices on board.
- ■Customers requiring a stretcher or an incubator
- ■Customers whose medical conditions may suddenly change
- ■Customers whose recent illness, injury or surgery may be affected by air travel.
- ■For pregnant women who are within 28 days of their due date. Others
Get a Medical Information Form (MEDIF) from here
The form consists of 4 sections (Guidance for Customers with Medical Requirements, Guidance for the Physician, Medical Information Form (MEDIF), and Special Assistance for Boarding).
Page 1 & 2 are references for completing the medical certificate.
Page 3 must be completed by your physician.
Fill out page 4 for details and requirements for boarding
Passengers using medical oxygen cylinders or medical equipments on board, please also read the information titled,“Passengers with an illness or injury”
Mail or Fax Service
In case you cannot download/print the pdf file of MEDIF/Oxgen Cylinder Check Sheet, please contact us and we will send them by mail or fax.
MEDIF must be issued by the physician within 14 days including the date of departure
Example: If the departure date is Dec. 15, the MEDIF must be issued no earlier than Dec. 2.
A MEDIF must be certified by your physician that you are fit to travel by air. If your flight is round-trip, check the Applicable or Not Applicable box for your return flight in the MEDIF.
If your flight is round-trip and you are unable to have your certificate issued within 14 days before your return flight, you must specify the duration of travel (the trip departure and return dates) in the certificate for the outbound flight.
Expectant mothers traveling within 28 days of delivery must carry a doctor's note issued within 7 days prior including the departure date.
Please see “ANA Easy Travel for Families -Expectant mothers- (Japan domestic flights / Internationl flights)” for further details.
Please let us confirm your MEDIF in advance.
Please fax or e-mail Specail Assistance Inquiry Form (as attached) your MEDIF to ANA Disability Desk in advance.
By confirming your medical information beforehand, it makes your check in procedure easier on departure day. Please send it to us a few days prior to your departure. Our staff may contact you in case any information is missing on your MEDIF.
Otherwise, please bring your MEDIF with you and show it at the check-in counter on your departure day.
Patient's Name, Age, Gender, Diagnosis or Condition.
- Prognosis for flight
Must be filled in
PROGNOSIS for return flight (if any)
- Infectious or Communicable Diseases
If marked yes, please specify.
- Able to sit upright with seat belt fastened.
If marked no and a stretcher is required, please mark as applicable
- Requirement of an accompany.
- Requirement of medical oxygen on board
If marked yes, please specify amount and frequency
- Requirement of medical equipment on board
- Requirement of medical treatment on board
- Other special assistance required for boarding
Name (Signature), Name of Medical Center or Hospital, Address and Telephone number.
Date of Issue