Information before traveling by air

For doctors and passengers

Long flight time and pressure change caused by changing flight altitude, may sometimes adversely affectpassenger’s medical condition. For these reason, air travel may not be suitable for all passengers.

Handling of Personal Information
STARFLYER may share this MEDIF with a designated organization of medical specialists, who might
contact customers if necessary.

Cases when Medical Information Form (MEDIF) is requested
Person traveling with any of the following conditions are requested to notify our reservation staff and will beasked to prepare MEDIF when making a flight reservation.
①

Person requiring medical oxygen or medical equipment or medical treatments on board.

②

Person with serious diseases or injuries③

Person who correspond to any of the categories listed on the next page.(GUIDANCE FOR THEPHYSICIAN)④

Other than above. Person traveling by air may have adverse affects to one’s medical conditions due torecent treatment or surgery.

Submitting MEDIF

For doctors and passengers

MEDIF must be prepared and issued within 14 days, including the day of departure. (Example: If thedeparture date is March 16, the MEDIF must be issued no earlier than March 3.) For round-trip flight,
the date of return flight may exceed 14 days if it states “Fit to travel” in the appropriate box of MEDIF.
However, if adverse change of the passenger’s medical condition is observed our staff may ask to submit
a new MEDIF to reconfirm the fitness for air travel.
If the validity period of the medical certificate is specified separately by the doctor, it will be accepted as avalid medical certificate as long as the date of boarding is within the validity period.

Filling out MEDIFFor doctors

Please consider the itinerary and its potential effect on the patient's state of health when writing prognosis
for the flight. Specify details if any other special attention should be considered in the lower part of MEDIF.

Fee or surcharge

For doctors and passengers

Fee if any, relevant to the provision of “Special Assistance Request” or MEDIF and for carrier-provided
special equipment are to be paid by the passenger concerned.
For following cases, the passenger must purchase extra seats.
*an oversized medical equipment that cannot be stored underneath the seat in front
For flight safety reasons, some medical equipment may not be allowed in cabin or as checked baggage.
Please contact SF CALL CENTER for specific regulation.
The cabin environment and effect on one’s body
For doctors and passengers
Aircraft cabin pressure is regulated by pressurization device at between 0.7-0.8 bars (10.2psia to 12psia), which equals
to that at an altitude of 2000-2500 meters However, significant changes in cabin pressure can occur 15-30 minutes after
takeoff and before landing.
As air pressure becomes lower in the cabin, normal internal gases present in the human body expand. These expandedgases not discharged from the body may put pressure on wounds or internal organs possibly cause pain or breathingdifficulties.
The cabin pressure drops oxygen density to 70-80% of that at sea level.
Respiratory organs, the heart, blood vessels in the brain and serious anemia can all be adversely affected by low oxygen
concentrations. Moreover, this may also affect women in late stages of pregnancy and newborn babies.

GUIDANCE FOR THE PHYSICIAN AND PASSENGER

For doctors and passengers

As stipulated in the Japan Act on the Prevention of Infectious Diseases and Medical Care forPatients with Infectious Diseases, persons suffering from or suspected of having a Class 1, 2,3 or 5 infectious disease, a new strain of influenza, a new infectious disease, or anotherserious acute infectious disease which may infect other persons on board and shall not bebasically allowed to travel by air.
Person’s condition which is not fit to travel▮A person who is prohibited from attending school by Japanese law(“Act on School Health and Safety”)
Other than above, a person who is prohibited from attending school by Japanese law(*1) shall not beallowed to travel by air unless a physician confirms that there is no risk of the disease to be transmit fromperson to person.
（*1）

The name of a disease
COVID-19
Influenza
Whooping coughMeasles
Mumps
Rubella
Chickenpox
Pharyngoconjunctival
Tuberculosis, Epidemic
keratoconjunctivitis, Acutehemorrhagic conjunctivitis

Until 5 days have passed after onset,and 1 day have passed after
become less severe.
Until 5 days heve passed after onset, and 2days(3days for infants) havepassed after the temperature have dropped
Until the characteristic cough has suppressed, or until 5days treatment
with antibiotics has ended.
3 days after his/her temperature has dropped
After 5days of onset of the swelling on submandibular, sublingual andparotid gland, and major symptoms general condition recovered
Until eruption disappears
Until the eruption changes to scab
2 days after the main symptom disappears
Until a physician evaluates that the disease becomes non-contageous.

❚Person with other symptoms or conditions
Persons with the following conditions are generally considered unfit for air travel. However, if a physician
certifies that the patient is stable, and that physician will be accompanying him/her on the entire journey,
the airline may accept that individual for travel. Please contact STARFLYER for further information.
1.
2.

Those who have critical cardiac disease, severe heart diseases such a cardiac failure, cyanotic heartdisease conditions, who have had an episode within the past 6 weeks are not acceptable for travel.
Those who have unstable angina pectoris, acute myocardial infarction, who have had an episode within
the past 2 weeks are not acceptable for travel.

3.

Those who have severe respiratory illness, server respiratory failure, severe chronic obstructive
pulmonary disease, or pneumothorax whose lungs are not fully inflated.

4.

Those who have repeated hemoptysis

5.

Those with apoplexy who have had an episode within the past 4 weeks are not acceptable for travel.

6.

Those lesions resulted in increased intracranial pressure, fracture of the skull, or those who underwent
permanent wiring in the jaws for mandibular fracture

7.

Those who have severe anemia

8.

Those with lesions which may cause hematemesis, or melena, intestinal obstruction patients

9.

Those who have severe otitis media

10. Those who have not completely recovered from surgery of head, chest or abdomen or women
immediately after childbirth
11. Alcoholism or drug addiction
12. Those who have residual air or other gas in his/her body after operation. (for example eye operation)
13. Pregnant woman whose confinement may be expected in less than 28 days. However an escort by aphysician will be required if traveling by aircraft within 14 days of the expected confinement forinternational flights and 7 days for domestic flights.
14. Newborn baby within the first 7 days of birth.
EndSPECIAL ASSISTANCE REQUESTTo be completed by the passenger or representative

Please answer ALL questions. Enter a cross (X) in the appropriate "yes" or "no" boxes.
Use BLOCK LETTERS when completing this form.
PATIENTS
Age
NameContact Info
Itinerary /Flight Info

TEL:

TEL:

Date:

Flight No.:

Travel Segment (DEP-ARR):(

－)

Date:

Flight No.:

Travel Segment (DEP-ARR):(－)

Escort name

Physician
Nurse
Others (Escort name)

Physician
Nurse
Others ()＊Our cabin crew members can assist you in using the onboard wheelchair and stowing or retrieving carry-on items, identifying in-flightmeal items, and opening packages. However, our cabin crew members are not permitted to provide medical services, assist withfeeding or personal hygiene and lavatory functions. For those customers requiring such assistance, it is recommended to travel withan escort.
1 Wheelchair needed?
No
Yes→

Can not walk by myself
Can walk alone but can not ascend or descend stairs by myself
Can ascend or descend stairs by myself but can not walk long distance

2Wheelchair needed in cabin?

No3

Please tell us about yourpersonal wheelchair.

No wheelchair
Personal wheelchair＊From Aug 10, 2012,

Yes*You can check your wheelchair at the counter. We will takeyou to the plane in our wheelchair.

ManualElectric/Battery-powered→passengers will be allowed totransport spare Li-ion/Lithiumion batteries that power themobility device. If the battery is
not fully encased and protected
to prevent short circuit, thebattery must be removed andtransported in the cabin of theaircraft. Please inform us inadvance for limitation may apply.

Spillable Battery (Wet-cell “non-sealed”)
Non-spillable Battery (Wet-cell “sealed”)
Dry Battery * (□ Li-ion/Lithium-ion □ Ni-Cd □ Ni-MH)*Please specify

FoldableNon-foldable →If your wheelchair is non-foldable or battery-powered,please tell us thesize and weighr.
Length _________________cm Width_________________cm
Height _________________cm Weight_________________kg*We may not be able to accept large-size wheelchairs due to the size of thecargo door and space.
＊When you check your electric / battery-powered wheelchair, please tell our airport staff your wheelchair`s.

specific battery type and instructions to disconnect / insulate the battery since some batteries are considered
as“dangerous goods” and are permitted on passenger aircraft only under certain conditions.

4 Is Oxygen Cylinder needed

NoYes→in flght?
5

Ambulance arranged? (Ambulance must be arranged by the passenger)►Departure point►Arrival point
6

Personal medical oxygen cylinders

Company nameContact Info

Company name
Destination (Hospital Name)

Contact Info

Special instructions/Precautions

MEDICAL INFORMATION FORM（MEDIF）

To be completed by ATTENDING PHYSICIANThe Physician Attending is requested to answer ALL questions. Enter a cross (X) in the appropriate boxes, and/or give
precise concise answers. STARFLYER or a designated medical organization may contact the customer for clarification ifnecessary. Completion of the form in BLOCK LETTERS will be appreciated.
PATIENTS
AGE
NAME,INITIAL(S)MEDICAL DATADIAGNOSIS in details Please write so that non medical personnel are able understand.
(including vital signs)

Date of first symptoms/
Date:
Diagnosis

For expecting mother(Estimated delivery date) Date:(Date of Operation)

Diagnostic content
1

PROGNOSIS for the flight(s)* Please consider the itinerary and its
potential effect on the patient's state ofhealth

Fit to Travel

One-Way ltinerary

NOT Fit to Travel

Round-Trip ltinerary Date of retum flight ____________________*For round-trip itineraries, please also enter the departure date of the lastflight in your itinerary2
3

4Contagious AND communicable
Disease ?

Yes

Can sit upright with seat belt
fastened ?
(during take-off and landing)Yes

Is the patient fit to travel
unaccompanied?

YesNo, Must be accompanied by Physician or Nurse
No, Must be accompanied by a person who
Is approved by Physician→If Yes,may the disease be infectious to other persons?

NoNo

Yes
No→If not,Stretcher shall be necessary.However,as STARFLYER does not off stretcher atthis time,those passengers cannot fly with us.We are sorry.

Escort name［］

5

Oxygen needed in flight?

Yes
No

6

Do you need oxygen continuously?

YesNo

7

Does patient need any medical
equipment in flight?
(e.g., ventilator, oxygen concentrator,etc.)* If you bring oversized medical
equipment that cannot be stored
under the seat in front, you may
need to purchase another seat.

Yes→If yes, specify

No❚The Name of Medical Equipment___________________________________________________________________

8

Does patient need any MEDICATION
In flight?

Yes

9Specify more details, if necessary

If yes, please enter the amount of oxygen.
Liters per minuteℓ/minute❚Manufacturer or Distributor /Product name / type or model number_____________________________________________❚Battery type and capacity/size___________________________________________________________________→If yes, specify

No

Prognosis as above. I will provide necessary information required by the airline's medical department for the purposeof determining his/her fitness to travel by air with consent of the patient.
PHYSICIAN
Signature
Hospital Name
Phone No.

Address

Date of medicalcertificate issued

Expiration date ofthe medicalcertificate* If no expiration date is indicated on the medical certificate, a medical certificate issued within 14 days including the boarding date will be accepted asa valid medical certificate.
* Our cabin crew members are trained only in FIRST AID and are NOT PERMITTED to administer any injection, or to give medication, or to operate
Medical Oxygen cylinders. Additionally, they are not authorized to provide personal care services to particular passengers, to the detriment of theirservice to other passengers and cabin safety.