Special assistance request
In order to ensure that you are provided with the level of assistance required, please complete the special assistance form below no later than 48 hours before your departure date. A member of the team will contact you once your request has been received. If you are taking a mobility aid then please disregard this form and complete the relevant form instead.
Section 1 - Flight and Passenger Details
Passenger Name
*
First Name
Last Name
Booking Reference
*
These usually start with the letter A and contain six characters
Telephone Number
*
Please include any dialling or regional codes
Email
*
example@example.com
Type of journey
*
One way
Return
Outbound Flight Number
*
Can be found on your booking confirmation
Outbound Flight Date
*
-
Day
-
Month
Year
2 digit day, 2 digit month, 4 digit year
Date of departure
Return Flight Number
*
Can be found on your booking confirmation
Return Flight Date
*
-
Day
-
Month
Year
2 digit day, 2 digit month, 4 digit year
Date of return
I require assistance from the check in desk, to the bottom of the aircraft steps. (Passenger must be to walk up the aircraft steps)
*
YES
NO
I require assistance from the check in desk, to the top of the aircraft steps; carried/lifted onboard. (Not available on a Jetstream 41 aircraft)
*
YES
NO
I require assistance from the check in desk, to my seat onboard the aircraft; carried/lifted onboard. (Not available on a Jetstream 41 aircraft)
*
YES
NO
I have a sight impairment.
*
YES
NO
I wish to take a registered guide dog.
*
YES
NO
I have a hearing impairment.
*
YES
NO
I require general assistance due to a hidden disability or travelling with a young child/infant/elderly.
*
YES
NO
Please detail further:
*
I wish to take my own mobility aid.
*
YES
NO
Section 2 - Reduced mobility aid information
Mobility aid type
*
eg. wheelchair, scooter, walking stick etc
Manufacturer
eg. Solax
Make
eg. Mobie
Model / Type
eg. Manual folding (please provide as much information as possible)
Battery Type
eg. Dry cell, gel cell, lithium-ion (we do not accept wet cell)
Maximum dimensions of the chair or scooter
Rows
cm
inches
Length
Width
Height
Weight of mobility aid (kg)
Please consult your user guide if unknown
Maximum tyre width across the tread of tyre
Rows
cm
inches
Front Tyre(s)
Rear Tyre(s)
Can the mobility aid be disassembled?
Yes
No
Are you able to disassemble your mobility aid by yourself?
Yes
No
Can you provide instructions to the airport staff?
Yes
No
Can the battery be removed?
Yes
No
Maximum dimensions of the largest part if dismantled
Rows
cm
inches
Length
Width
Height
Weight of the heaviest part that can be separated if dismantled (kg)
Date completed
*
-
Day
-
Month
Year
2 digit day, 2 digit month, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Type name
*
Signature
*
Submit
Should be Empty: