Travelling with health concerns

Our top priority at WestJet is the health, safety, and comfort of our guests and crew. Guests are advised that air travel may negatively affect their overall medical condition. If a medical emergency occurs onboard an aircraft, coordinating an unplanned landing to access high-quality ground medical care can take additional time to coordinate. 

If you are affected by any of the medical conditions listed below, we recommend you review your plans and this information with your physician to ensure you are safe to fly before confirming your travel. Additionally, it may be necessary to consult with our health professionals at the Medical Desk to ensure that you have a safe and comfortable flight.

Please click on the buttons below to access a printable version of our Medical Information Form and our Information for Health Care Providers Document.

Medical Information Form
Information for Health Care Providers

Any charges incurred for the completion of this form will be at your expense. WestJet will not provide you with compensation if you are not approved for accommodation.  Please note: Medical Information Forms will be retained for a minimum of three years and handled in accordance with the WestJet Privacy Policy.

Follow up with your physician to discuss whether you should travel if you are sick or unwell before departure. All guests who appear sick or unwell at the airport may be subject to medical screening at the discretion of our WestJet agents or cabin crew. 

If you have one or more of the following medical conditions, please review your health status with your physician to determine if you need to submit our Medical Information Form.

  • Active infectious conditions such as, but not limited to, tuberculosis, chicken pox and measles 
  • Blood conditions:
    • Clotting disorders where your condition and treatment require monitoring by your physician
    • Leukemia
    • Severe anemia
  • Broken bones/fractures:
    • Casted limb within 48 hours of departure
  • Cancer with active treatment
  • Cognitive, behavioral and psychological conditions: 
    • History of condition deteriorating during previous flights
    • Not orientated x3 (to person/place/time)
    • Unstable/unpredictable or aggressive behavior/agitation
  • Ear, nose, sinus or throat disorders:
    • Current ear infection with the inability to clear ears 
    • Eye surgery where gas has been instilled and not absorbed 
    • Post-operative middle ear or nasal surgery within 10 days of departure 
    • Recent jaw surgery within a week of departure 
    • Tonsillectomy within 3 weeks of departure
  • Gastrointestinal issues:
    • Abdominal surgery within 14 days of departure 
    • Bleeding within 10 days of departure 
    • Laparoscopic surgery within 5 days of departure
  • Heart conditions and lung conditions:
    • Currently symptomatic or unstable 
    • Inability to walk 50m without significant shortness of breath or chest pain 
    • Oxygen is required during the flight — please discuss with your physician whether you need medical clearance to travel 
    • Recent deterioration 
  • Infant:
    • 7 days old or less 
    • Complex medical needs
    • Premature
  • Medical procedures and surgeries:
    • Surgery within 14 days of departure
  • Neurological conditions:
    • Head trauma less than 48 hours of departure 
    • Seizures within a month of departure 
    • Stroke within 14 days of departure 
    • Transient ischemic attack within 72 hours of departure 
  • Pregnancy:
    • Singleton equal to or greater than 36 weeks gestation
    • Multiple equal to or greater than 32 weeks gestation
  • Recent medical event on board a commercial aircraft or at the airport
  • Severe allergies

Air travel with medical conditions

There are numerous factors to consider when determining if your patient is medically fit to fly. Air travel can have low humidity, turbulence, prolonged periods of immobility, and requires a patient to sit upright in an aircraft seat. Several other factors can lead to deterioration of a medical condition on board, including: 

  • Gas expansion at altitude - As an aircraft ascends to cruising altitude, any gas trapped in the body will expand. In fact, the volume of gas can expand up to 30%, causing significant issues in specific instances. It may be important for your patient to consider delaying air travel if they have had recent surgery (especially in a small space such as the eye or ear) or recent pneumothorax (collapsed lung).
  • Altitude and its effect on oxygen levels - Our aircraft are pressurized to altitudes equivalent to 5000-8000 ft above sea level. At this altitude, there is less oxygen available. Healthy individuals will not notice this change, but those suffering from severe anemia, cardiac or pulmonary conditions could be at risk of severe hypoxia. Some individuals may require a Personal Oxygen Concentrator (POC) on board an aircraft to supplement their oxygen needs, even if they do not require oxygen on the ground. In these instances, consider delaying air travel until their condition is stable. To learn more information about oxygen needs, click here. 
  • Limited access to medical care on board -  In the event of a medical issue on board, our crews are trained in first aid and cardiopulmonary resuscitation (CPR). However, access to higher level medical care can take a prolonged amount of time, depending on many factors.

 

When should a WestJet Medical Information Form be completed (MEDIF)?

Please consider filling out a WestJet Medical Information Form for your patient if they have any of the following conditions or illnesses:

a) Any medical condition or illness that may deteriorate while on board the aircraft and potentially impact other guests. Examples may include severe heart disease, active infectious diseases, neurological issues, or unstable psychiatric illnesses. 

b) Any medical condition or illness that may worsen because of conditions on board the aircraft at cruising altitude. Examples may include a recent surgery where air is introduced into a body cavity, recent epistaxis, severe respiratory disease, or recent pneumothorax. 

c) Any potentially contagious infectious diseases such as tuberculosis, chicken pox, or influenza.

A completed WestJet Medical Information Form provides the information required to determine if a guest with remarkable underlying health issues is medically fit to fly. The type of medical information gathered complies with international air travel guidelines. The information provided is retained in accordance with WestJet’s Privacy Policy and the requirements of the Canadian Transportation Agency's Accessible Transportation for Persons with Disabilities Regulations. 

The guidance provided is in accordance with the International Air Transport Association’s guidelines. 

Cancer

Diagnosis MEDIF is not required if all criteria are met Considerations
Any cancer undergoing chemotherapy treatment
  • No recent chemotherapy has been administered
  • Symptoms are controlled
  • Hgb >90g/L and electrolytes are in the normal range
  • Patient should not fly during active administration of a cytotoxic medicine, especially when this involves slow-release cytotoxic drugs via vascular access

Cardiac and vascular conditions

Diagnosis MEDIF is not required if all criteria are met Considerations
Ablation therapy
  • >48 hours with stable rhythm
  • Patients flying within a week of the procedure are considered high risk for DVT
Angina
  • No symptoms at rest 
  • Can walk 50m without significant shortness of breath or chest pain
  • Symptoms controlled with medication
  • Angina with minor exertion may require O2 in flight (CCS III)
  • Individuals with symptoms at rest should defer travel (CCS IV)
Angiography
  • >24 hours with original condition judged as stable
Angioplasty with or without stent
  • >3 days, asymptomatic and stable underlying health issues
Cardiac surgery
  • 4 weeks post procedure without complicating factors 
  • Stable medications
  • CXR excluding pneumothorax 
  • Hgb >90 g/L
Congestive heart failure
  • Controlled and stable chronic heart failure
  • No exacerbations in the past 6 weeks
  • Able to walk 50m or one flight of stairs without shortness of breath or chest pain
  • Symptoms with exertion (NYHA class 3) may require O2 in flight 
  • NYHA class 4 should defer all non-essential travel and must fly with inflight O2
Cyanotic congenital heart disease
  • MEDIF form necessary for all patients
  • Consideration of inflight O2 in all cases
Deep venous thrombosis
  • Asymptomatic and stable on anticoagulant therapy
Hypertension
  • Not required for isolated hypertension
  • Travel should be deferred for those with severe and uncontrolled hypertension
Myocardial infarction (STEMI and NSTEMI)
  • MI >2 weeks ago and is asymptomatic with stabilization of medications
  • Low risk-<65 years of age, first event, successful reperfusion, EF >45%, no complications, no investigations or interventions planned may fly earlier with approval 
  • High Risk-EF<40%, heart failure, pending investigation, revascularization, or device therapy should have travel deferred until stabilization of the condition
Pacemaker or defibrillator implantation
  • >2 days if rhythm is stable
  • CXE has ruled out pneumothorax
Pulmonary edema
  • Resolved pulmonary edema 
  • Resolution of the precipitating condition
Pulmonary embolism
  • >2 weeks since onset 
  • Adequate anticoagulation 
  • Asymptomatic
  • Consideration can be given to those requiring essential travel after 5 days if adequately anticoagulated, asymptomatic and PaO2 normal on room air

Central nervous system disorders

Diagnosis MEDIF is not required if all criteria are met Considerations
Cognitive impairment including dementia
  • Mild impairment
  • Functions independently in the community
  • No paranoia, aggressive behaviour, or agitation.
  • No history of deterioration in flight.
  • Patient is alert and orientated x3 (person/place/time)
  • Consider support of an attendant
CVA (stroke)
  • 14-28 days since event
  • Stable condition
  • Medical Desk will consider flight prior to 14 days but supplemental O2 will be required
Head trauma
  • Mild concussion
  • Minimal symptoms (headache only)
  • Injury >48 hours
  • Recent (<4weeks), skull fractures, subarachnoid or subdural bleeds all require Medical Desk approval
Seizures
  • Stable control with no seizures in the past 30 days
  • Flight is contraindicated if unstable seizure disorder or grand mal seizure in the past 24 hours
  • Relative hypoxia onboard can lower the seizure threshold in some individuals
Syncope
  • Age <70 with classic vasovagal syncope
  • Age >70 and non-vasovagal syncope investigated, and underlying condition stabilized
  • >24 hours since episode
TIA
  • >72 hours since event
  • Asymptomatic
  • Investigations completed
  • Crescendo TIAs should avoid travel

Ear, nose and throat disorders

Diagnosis MEDIF is not required if all criteria are met Considerations
Dental procedures
  • >24 hours since procedure
  • Pain controlled
  • Recommend all patients with recent dental procedures bring their own prescribed or over the counter pain medication for travel
Epistaxis (nosebleed)
  • Bleeding has stopped for more than 24 hours
  • No packing is in place
  • Hgb >90 g/L
Middle ear surgery
  • >10 days since surgery
  • Uncomplicated surgery
  • Clearance from ENT surgeon
Nasal surgery
  • >10 days postoperative
  • Uncomplicated surgery
  • ENT clearance to fly
Otitis media or sinusitis
  • Able to clear ears
  • Illness is improving
  • No additional infectious disease concerns (e.g., COVID-19)
Tonsillectomy
  • >3 weeks since surgery
  • Hgb >90 g/L
  • Due to bleeding risk, travel prior to 3 weeks will require Medical Desk approval with consultation with ENT surgeon
Wired jaw
  • Escorted travel with knowledge of how to use cutters to remove in an emergency
  • Unescorted quick release wiring

Gastrointestinal disorders

Diagnosis MEDIF is not required if all criteria are met Considerations
Diverticulitis
  • Symptom resolution
  • Antibiotics completed
  • Chronic disease not requiring antibiotics
  • Travel is contraindicated with acute symptoms (pain/fever)
Gastrointestinal bleed
  • No bleeding in > 10 days
  • Hgb > 90g/L
  • 1-9 days may consider travel if endoscopic confirmation and rising Hgb levels
Major abdominal surgery (bowel resection, open hysterectomy, renal surgery)
  • Uncomplicated surgery >14 days ago
  • Hgb >90 g/L
  • Pain controlled
  • Time can be reduced to 7 days if the intestinal lumen was not opened
Nausea/vomiting/diarrhea
  • 24 hours past the last episode of vomiting and diarrhea and is currently asymptomatic
  • Travel is contraindicated with active symptoms or symptoms of dehydration
Uncomplicated laparoscopic surgery (appendectomy, tubal ligation, gall bladder removal)
  • >5 days if uncomplicated recovery
  • More complex laparoscopic procedures such as a hemicolectomy would follow major abdominal surgery requirements
  • Flight prior to 5 days will be considered if bloating symptoms are absent

Hematological conditions

Diagnosis MEDIF is not required if all criteria are met Considerations
Acute leukemia
  • Stable remission
  • Hgb >90g/L
Anemia
  • Hgb > 90g/L and underlying health conditions are stable
  • If acute anemia, repeat Hgb should be completed 24 hours after last blood loss
  • Supplemental O2 should be considered for significant anemia or those with concurrent lung or cardiac disease
Bleeding disorder
  • Air travel is contraindicated if active bleeding is occurring
Clotting disorder
  • Anticoagulation is stable
Sickle cell disease
  • Always require supplemental O2

Ophthalmologist disorders

Diagnosis MEDIF is not required if all criteria are met Considerations
Cataract surgery
  • >24 hours and uncomplicated surgery
Corneal laser surgery
  • >24 hours and uncomplicated surgery
Intra-ocular surgery
  • Depending on the gas injected in the globe, travel may be required to be delayed for 2-6 weeks
  • Prior to travel, ophthalmologist will need to confirm fitness to fly and confirm gas used
Penetrating eye injury
  • >7 days since injury
  • Any gas in the globe must be resorbed
  • Confirmation with ophthalmologist prior to travel

Orthopedic conditions

Diagnosis MEDIF is not required if all criteria are met Considerations
Arthroscopic joint surgery
  • Able to mobilize with a walking aid
  • Able to sit fully upright for take-off and landing
  • Pain controlled
Full plaster cast flight >2 hours
  • >48 hours since cast placed
  • Hgb >90g/L
  • No other injuries of significance
  • Able to mobilize with a walking aid
  • Able to sit fully upright for take-off and landing
  • Risk of DVT on longer flights so consideration for anticoagulation should be considered
Major hip, knee, or ankle surgery
  • Surgery >14 days prior
  • Able to mobilize with a walking aid
  • Able to sit fully upright for take-off and landing
  • Pain controlled
  • Post-operative Hgb > 90 g/L
  • DVT prophylaxis is important and should be assessed if surgery was in the past 6 weeks
  • If DVT prophylaxis is not utilized, longer travel in the first six weeks travel should only be taken if essential
Spinal surgery
  • Uncomplicated surgery >14 days ago
  • Pain controlled
  • Must be able to sit upright for take-off and landing
  • Must be able to tolerate unexpected turbulence and vibration
  • Attendant would be required if unable to provide self-care

Pregnancy

Diagnosis MEDIF is not required if all criteria are met Considerations
Complicated Pregnancy or history of preterm labour
  • Consideration will be given on an individual basis in consultation with treating obstetrician
Miscarriage
  • No active bleeding or pain for at least 24 hours
  • Hgb >90 g/L
Singleton pregnancy
  • <36 weeks gestation
  • Uncomplicated pregnancy
  • No history of preterm labour
Multiple pregnancy
  • <32 weeks gestation
  • Uncomplicated pregnancy
  • No history of preterm labour
Newborn
  • Fit and healthy babies after 7 days

Psychological conditions

Diagnosis MEDIF is not required if all criteria are met Considerations
Chronic psychiatric disorders
  • Medical condition is stable and risk of deterioration inflight is judged to be low
  • Individual is living in the community independently
  • No episodes of acute psychosis (mania, schizophrenia, drug induced) in the past 30 days
  • Patient is alert and orientated x3 (person/place/time)
  • Medication should be carried onboard
  • Attendant should be considered if any risk of deterioration with the stress of travel
  • Alcohol avoidance should be encouraged

Respiratory conditions

Diagnosis MEDIF is not required if all criteria are met Considerations
Asthma
  • Mild asymptomatic asthma
  • No recent hospitalizations for asthma
  • Travel with medications in carry-on
Chest surgery (lobectomy, pleurectomy, open lung biopsy)
  • ≥11 days after surgery without complication
  • No pneumothorax on x-ray
COPD, emphysema, pulmonary fibrosis, pleural effusion or hemothorax
  • O2 sats >93%
  • Able to walk >50m or 2 flights of stairs with minimal symptoms
  • No other cardiac or remarkable health issues
  • Moderate COPD may require inflight O2
Lung cancer
  • Asymptomatic
  • Hgb >90g/L
  • No large effusions on CXR
  • Large hemoptysis, regardless of diagnosis, is contraindicated for flight
Oxygen
  • For patient whose O2 requirement is ≤4 L/minute at rest, guidelines advise increasing the O2 flow by 1 to 2 L/minute while in flight
Pneumonia
  • Fully resolved and symptom free
  • Consider supplemental O2 in cases of recent episode, elderly passengers, or longer flights
Pneumothorax
  • 14 days after full inflation confirmed by CXR
  • Consideration may be given to those with a non-traumatic pneumothorax 7 days after inflation confirmed by CXR
Pulmonary Hypertension
  • NYHA Class I
  • Stable Medications
  • All other classes require review by Medical Desk
Ventilators
  • Stable requiring ventilation only with air

Miscellaneous conditions

Diagnosis MEDIF is not required if all criteria are met Considerations
Allergies and anaphylaxis
  • Submit MEDIF if a buffer zone is required.
  • We are unable to guarantee an allergen-free environment as our aircraft are open to the public
  • Recommend travel with medications including epinephrine autoinjector (for anaphylaxis) in carry-on.  Patient must be able to self-administer or an attendant must accompany the patient.
Communicable diseases
  • Travel during contagious stage of the illness is contraindicated
Patients treated with radionuclides or permanent brachytherapy
  • Travel plans should be reviewed by nuclear medicine department
  • Individual risk assessments may be required including dose rate estimate in microSV per hour at 0.5m
  • All cases need documentation for security radiation detection purposes
Scuba diving
  • >24 hours following uncomplicated scuba diving
  • >72 hours if multiple dives in the three days prior to travel
  • Decompression illness will generally require 3-7 days after treatment after consultation with treating physician
Terminal illness
  • Individual assessment of cases must occur
  • Consideration must be given to mobility, lung function, bowel and urinary function, pain control
  • Attendant may be required

 

References:

Fitness to fly for passengers with cardiovascular disease, The report of the working group of the British Cardiovascular Society, Heart 2010;ii1-ii16. doi:10.1136/hrt.2010.203091

Coker, R. K., Armstrong, A., Church, A. C., Holmes, S., Naylor, J., Pike, K., Saunders, P., Spurling, K., & Vaughn, P. (2022). BTS Clinical Statement on air travel for passengers with respiratory disease. Thorax, 10(1136), 1-22.

Medical manual. IATA. https://www.iata.org/en/publications/medical-manual/. Published July 12, 2020. Accessed September 8, 2022.

Managing passengers with stable respiratory disease planning air travel: British Thoracic Society recommendations. Thorax, Sept. 2011, Vol 66, Supplement 1.

Thibeault C, Evans AD, Dowdall NP. Asma Medical Guidelines for air travel: Fitness to fly and Medical Clearances. Aerospace Medicine and Human Performance. 2015;86(7):656-656. doi:10.3357/amhp.4222.2015.

NYHA: New York Heart Association NYHA Class Symptoms

I No symptoms and no limitation in ordinary physical activity, e.g. no shortness of breath when walking, climbing stairs etc.

II Mild symptoms (mild shortness of breath) and slight limitation during ordinary activity.

Ill Marked limitation in activity due to symptoms, even during less-than-ordinary activity, e.g. walking short distances (20-100 m).  Comfortable only at rest.

IV Severe limitations. Experiences symptoms even while at rest. Mostly bedbound patients.

Access our Medical Information Form to fill out with your physician. The WestJet’s Information for Health Care Providers Document contains information your doctor will need to consider regarding your safety to fly. Any charges incurred for the completion of this form will be at your expense. WestJet will not provide you with compensation if you are not approved for accommodation.  Please note: Medical Information Forms will be retained for a minimum of three years and handled in accordance with the WestJet Privacy Policy.

Please submit your request for medical clearance at least 14 days prior to departure. We cannot guarantee that forms received within 48 hours of your scheduled departure will be reviewed prior to your flight. Refunds of any fare type will not be provided for flights taken before an approval has been granted. All fees and fare guidelines for fare purchased will apply to previously booked flights.

If your travel itinerary includes a flight operated by another airline, please contact them to ensure you are meeting their requirements as it relates to your medical condition. Completed forms can be emailed to MedDesk@WestJet.com or sent in via fax to 1-866-737-1202. 

A medical certificate from your physician, dated within 10 days of the departing flight, will be accepted as an alternative to the WestJet Medical Information Form. The medical certificate must indicate your prognosis for a safe flight with no extraordinary medical assistance required on board, and confirm there is no indication of a contagious disease that would pose a risk to the safety of others on board.

We encourage all guests to review WestJet's Information for Health Care Providers Document with their physician and strongly suggest that the Medical Information Form be completed if indicated to ensure your medical condition will not worsen at altitude during flight.  

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