The Medical Letter For Flight Cancellation serves as an official document required when passengers need to cancel their flights due to medical circumstances. This document, governed by U.S. federal and state regulations, particularly HIPAA and the Air Carrier Access Act, provides airlines with verified medical information to process cancellations and potential refunds. The letter must balance detailed medical justification with patient privacy concerns, including specific symptoms or conditions that prevent safe air travel, while meeting both medical documentation standards and airline requirements.
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1. Patient Identification: Full name, date of birth, and relevant identifying information of the patient
2. Flight Details: Flight number, date, route, and booking reference details
3. Medical Condition Statement: Clear description of the medical condition preventing travel
4. Professional Medical Opinion: Medical assessment and certification of patient's inability to travel
5. Physician Information: Doctor's name, credentials, license number, contact information, and signature
1. Treatment Timeline: Details of when the condition began and expected duration, included when condition is temporary
2. Travel Restrictions: Specific limitations on travel, included when partial travel may be possible in the future
3. Medical History Reference: Brief relevant medical history, included when the condition is chronic or recurring
1. Medical Records Excerpt: Relevant portions of patient's medical records (with explicit consent)
2. Diagnostic Results: Relevant test results or diagnostic reports supporting the medical condition
3. HIPAA Authorization Form: Signed authorization for release of medical information to airline
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