Request for transportation of passenger on a stretcher

Personal data of the passenger (in Latin characters)

First name*

Surname*

Panorama Club card number

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Your contacts

E-MAIL *

Phone *

Personal data of the accompanying person (in Latin characters)

First name*

Surname*

Status*

Additional information

From (city)*

To (city)*

Departure date*

Ticket number *

RETURN FLIGHT DETAILS

From (city)*

To (city)*

DEPARTURE DATE OF RETURN *

Ticket number

Important: request for passenger transportation on a stretcher must be sent to UIA Contact Center no later than 72 hours before the scheduled flight departure. Providing the medical clearance form (MEDIF) is mandatory.

Passenger who can be transported only on a stretcher can be accepted for transportation on UIA aircraft provided free seats are available on the flight.

If transportation en-route involves the participation of other airlines, the passenger of this category can be accepted for transportation only at presence of confirmation from other carriers about such transportation.

* I hereby confirm the validity of all personal data herein and grant my consent to the processing of this personal data for the purpose of getting a response to my request, for the performance of the Contract of carriage and other carriage related additional services (for example, meals, all types of baggage, seat type selection, upgrade of comfort level, Unaccompanied Minor service). I declare that I and all passengers whose personal data I am providing, have been diligently informed about the UIA’s Carriage Agreement, Passenger and Baggage Carriage Rules and Privacy Policy and have accepted them conditions.

I hereby agree to the processing of my personal data for the purpose of receipt from UIA personalized offers and marketing materials with special offers for airline travel and other services, including e-News, joint promotional campaign (fares) of UIA and its partners, on Panorama Club loyalty programs in compliance with UIA’s Privacy Policy. I can withdraw my consent for commercial subscription at any time.

mandatory fields