Fit To Fly Pregnancy Letter Template UK

The Fit To Fly Pregnancy Letter Template UK is provided in multiple formats, including PDF, Word, and Google Docs, featuring editable and printable examples.

Open – Template

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Sample

Fit To Fly Pregnancy Letter Template UK

Editable – Printable

PDF – 1 PDF – 2

Fit To Fly Pregnancy Letter Template UK

1. Patient Information


2. Healthcare Provider Information


3. Medical History

4. Pregnancy Information

5. Fitness to Fly Assessment

6. Travel Details


7. Potential Risks

8. Special Instructions

9. Provider Declaration

10. Signatures and Agreement

11. Declaration and Signatures



PDF

WORD

Examples

Fit To Fly Pregnancy Letter Template UK (1)
To Whom It May Concern:
[Date]
Subject:
Fit To Fly Medical Certificate for [Patient’s Name]
Patient’s Details:
Name: [Patient’s Name]
Date of Birth: [Patient’s Date of Birth]
Contact Information: [Patient’s Address, Phone, Email]
Medical Declaration:
I, Dr. [Doctor’s Name], a licensed medical practitioner with registration number [Doctor’s Registration Number], hereby certify that I have examined [Patient’s Name] and confirm that she is in good health and fit to travel by air. This evaluation was conducted on [Date of Examination].
Pregnancy Status:
[Patient’s Name] is currently [Number of Weeks] weeks pregnant and has had a normal pregnancy thus far, with no complications. The expected due date is [Expected Due Date].
Recommendations:
I recommend the following precautions to ensure a safe journey:
– [Detail any specific recommendations such as staying hydrated, moving around during the flight, and consulting with an obstetrician if needed].
Fitness for Travel:
Given the current health status and pregnancy stage, it is my professional opinion that [Patient’s Name] is fit to fly on [Travel Dates] and can comfortably undertake the journey without complications. If there are any specific concerns during travel, please contact me at [Doctor’s Contact Information].
Signed:
[Signature of the Doctor]
Dr. [Doctor’s Name]
[Clinic or Hospital Name]
[Clinic/Hospital Address]
[Clinic/Hospital Phone Number]
Fit To Fly Pregnancy Letter Template UK (2)
To Whom It May Concern:
[Date]
Subject:
Fit To Fly Declaration for [Patient’s Name]
Patient’s Details:
Name: [Patient’s Name]
Date of Birth: [Patient’s Date of Birth]
Contact Information: [Patient’s Address, Phone, Email]
Medical Statement:
I, Dr. [Doctor’s Name], holding registration number [Doctor’s Registration Number], confirm after a thorough assessment that [Patient’s Name] is medically fit to travel by air. The assessment occurred on [Date of Examination].
Pregnancy Information:
[Patient’s Name] is [Number of Weeks] weeks pregnant. To date, the pregnancy is progressing without issues, and the expected delivery date is [Expected Due Date].
Travel Precautions:
It is advisable for [Patient’s Name] to follow these guidelines while flying:
– [List specific travel precautions such as wearing compression stockings, staying hydrated, and taking frequent walks in the aisle].
Suitability for Travel:
Based on the assessment, [Patient’s Name] is cleared for air travel on [Travel Dates]. Should any concerns arise during the flight, please feel free to reach out to me directly at [Doctor’s Contact Information].
Confirmation:
This letter is issued in good faith based on the current medical assessment. Should further information be required, please contact me.
[Signature of the Doctor]
Dr. [Doctor’s Name]
[Clinic or Hospital Name]
[Clinic/Hospital Address]
[Clinic/Hospital Phone Number]

Printable

PDF – 1 PDF – 2

Fit To Fly Pregnancy Letter Template UK