A Guide for Customers with Disabilities JAL PRIORITY GUEST SUPPORT

For Medical Certificate and Agreement

Medical Information Form (MEDIF)

Customers traveling with any of the following conditions are requested to prepare Medical Information Form (to be hereinafter MEDIF).

  1. Customers who need a stretcher onboard the aircraft
  2. Customers who need oxygen supply
  3. Customer carrying and using medical equipment and having any medical treatment onboard the flight
  4. Customers with serious illness or injury
  5. Customers whose fitness for air travel is in doubt, as evidenced by recent instability, disease, treatment or surgery
  6. The pregnant customers whose expected date of child delivery is less than 28days

Submission of Medical Information Form

  1. Please complete Medical Information Form.
    (Download and print the certificate in PDF format from the link below or request a certificate from opens in new window their nearest JAL reservations or sales office or JAL Priority Guest Center.)
  2. Pages 1 and 2 of the file contain instructions on completing the form and reference information. The Medical Information Form is on page 4 and should be completed by your attending physician.
  3. Page 3 contains the "Necessary Arrangement Request" and "Agreement" sections and should be completed by the customer.
    Upon completion, all documents should be sent in advance with the Medical Information Form by fax to us in advance.
    • *Send your Medical Information Form to:03-5460-5676 if you are in Japan.
  4. JAL will review the Medical Information Form and determine whether or not accommodations can be made for the customer.
    • *However for the pregmant whose expected date of child delivery is less than 28days, the medical certificate may not be sent to JAL Priority Guest Center in advance. Please submit the medical certificate upon check-in at the airport.

For details, please contact opens in new window their nearest JAL reservations or sales office or JAL Priority Guest Center.

JAL Priority Guest Center Send your Medical Information Form to
*The content of the conversation will be recorded or monitored to ensure the service quality.
FAX: 03-5460-5676


A credible medical certificate for an air travel must be issued within 14 days, including the day of departure, but excluding the cases below.

  • For use of stretchers : Must be issued within 10 days, including the day of departure
  • Pregnant woman whose confinement may be expected in less than 28 days : Must be issued within 7 days, including the day of departure
  • For newborn baby : Must be issued within 2 days, including the day of departure
  • *The deadline for submission is 48 hours prior to departure of the flight.

Medical Information Form Download

The Medical Information Form can be downloaded here. (PDF format)

PDF Medical Information Form (PDF format: about 255KB)

  • *In order to view PDF documents, you will need to install Adobe Reader on your computer.
  • opens in new window About PDF

How to Fill out MEDIF

:should be completed by the attending physician.
2 MEDA 1
:Applicant Write the customer's name, age, and gender.
3 MEDA 2
:Attending Phisician Write the name, name of hospital, and telephone contact.
4 MEDA 3
:Medical Data Write the details to ensure that we fully understand.
5 MEDA 4
:Fitness for Air Travel Write the patient's state of health.
6 MEDA 5
:Communicable Disease
7 MEDA 6
:Distress to Other Customers
8 MEDA 7
:Sitting Position [NO]: stretcher arrangements are needed. For details, please see [Customers Using Stretcher.]
9 MEDA 8
:Taking care of his/her own needs on board [NO]: escort(s) should accompany customer.
10 MEDA 9
:Escort(s) Arrangements
11 MEDA 10
:Oxygen Supply Write the need for oxygen and the rate of flow per minute required.
12 MEDA 11/12
:Medical equipment to be used.
13 MEDA 13/14
:Hospitalization at connecting points or upon arrival.
14 Remarks in Particular
:Write any comments about the patient's condition and any suggestions.
15 Signature and Date
:The statement must be dated and signed by the attending physician.

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* Customers in the U.S. who are deaf or who have a hearing or speech impairment and who use a text telephone (TTY) can call via the National Relay Service by dialing 711. The relay operator at the National Relay Service will assist customers by contacting Japan Airlines. For more information about the National Relay Service, please click below.

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