Part 1 - Medical Clearance Guest's Letter

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Effective 22 January 2021Part 1 - Medical Clearance Guest's LetterDear Guest,Virgin Australia is committed to ensuring that your flight with us is as safe and comfortable as possible.You should be aware that flying can cause complications for guests with certain medical conditions. VirginAustralia employees are not medically trained and can only provide limited assistance in the event of amedical emergency. It is for this reason that Virgin Australia provides Medical Clearance Guidelines(VAGP-MED-01) to assist guests and their treating doctor to understand some of the risks associated withair travel.When making a booking, you must inform Virgin Australia that you have a medical condition. We ask youto consult your doctor to find out whether it is safe for you to fly. You must provide your doctor with a copyof the Medical Clearance Guidelines (VAGP-MED-01) including the Medical Clearance Doctor's Letterand Medical Clearance Form. These must be completed by your treating doctor on determination that itis safe for you to travel. Any assessment or appointment with your treating doctor is at your expense.It is important that you bring a copy of Part 3 - Medical Clearance Form for each of your intended flightswith Virgin Australia.Photocopied or fax copies of the form are acceptable provided the information can be clearly read.In providing this completed form to Virgin Australia you are waiving the confidentiality of this informationdisclosed by your doctor. Virgin Australia may disclose the information on this form to any other carrierassociated with your ticket. However, Virgin Australia will not disclose the information on this form to anyother third party without your permission, or unless it is permitted by law. Please be aware that if you areexempt from the requirement to wear a face mask, there may be circumstances in which it is necessaryfor Virgin Australia to share with other guests that you have an exemption from wearing a face mask.Virgin Australia reserves the right to deny boarding if you have not obtained medical clearance or if weconsider that it is not in your best interests to fly.Please forward the completed forms:Email: VA.Medical@virginaustralia.comFax: ( 61) 07 3295 3100For urgent, complicated medical cases or any queries in relation to completion of the Part 3 - MedicalClearance Form, please contact the Guest Contact Centre on the following numbers:Within AustraliaAnywhere else in the world1300 139 303( 61) 07 3295 3941Thank you,Medical ServicesVirgin AustraliaVAGP-MED-01 V5.8 220121 Medical Clearance Guidelinespage 01 of 13

Medical Clearance Doctor’s LetterEffective 22 January 2021Part 2 - Guidelines to be referred to by medical practitionerThese guidelines must be used in conjunction with the Virgin Australia Medical Clearance Form (Part 3). In additionto these guidelines, when considering a passenger's suitability for air travel, the following must be considered:– Reduced atmospheric pressure. Cabin air pressure changes greatly during 15-30 minutes after take-off andbefore landing; gas expansion and contraction can cause pain and pressure effects.– Reduced oxygen tension. Cabin air pressure is equivalent to an altitude of 6000 to 8000 ft and oxygen partialpressure is approximately 20% less than at sea level.Use this form to determine if a passenger's medical condition makes them Unacceptable for Travel or if MedicalClearance required before travel. If Medical Clearance is required before travel, the Part 3 - Medical Clearance Formmust be completed by a medical practitioner (registered doctor).NOTE: Any medical condition which would render a passenger unable to complete the flight safely, withoutrequiring extraordinary medical assistance during the flight, is considered unacceptable for airtravel.This is not an exhaustive list of conditions. If a person has had recent surgery or suffers from an ailment not specifiedin the table below that may affect their health, they should consult a medical practitioner for travel advice and medicalclearance.Virgin Australia will consider a passenger’s medical condition on a case by case basis, however, thefollowing conditions are likely to be declined travel:1. Within 24 hours of a general anaesthetic.2. Uncontrolled bleeding.3. Unstable medical or psychiatric conditions.4. Uncontrolled pain.5. Known ectopic pregnancy.6. Decompression illness.7. Active tuberculosis or haemorrhagic fever.CODE/MEDICAL CONDITIONMEDICAL CLEARANCEREQUIREDCOMMENTSCATEGORY 1 - CARDIOVASCULAR AND CIRCULATORY CONDITIONS(1A) Heart attack(myocardial infarction)Within 21 days (see below).Recommend delaying air travel if:LOW RISK- less than 3 daysMEDIUM RISK- less than 10 daysHIGH RISK- until stable(see below).Unacceptable for travel if supplementaloxygen is required. Wheelchairassistance to limit ambulation may benecessaryAs per British Cardiovascular Society Guidelines, stratify according to risk:High risk EF 40% with signs and symptoms of heart failure or requiring furtherinvestigation/revascularization or device therapy- must be discussed with GuestContact Centre Team and travel delayed until stableModerate risk no evidence heart failure or inducible ischaemia or arrhythmia,EF 40% - delay travel 10 daysLow risk 1st cardiac event, age 65, successful reperfusion, EF 45%,uncomplicated and no further investigations or interventions planned- may fly 3 days.(1B) AnginaNot required if the condition iscontrolled and stable*Considered unacceptable for travel ifunstable angina(angina which despite treatment hasincreased in frequency and severity)Supplemental oxygen should not berequired to control the angina at rest* *must be able to walk at least 50mand carry out other Activities of DailyLiving (ADLs) without discomfort orbreathlessnessContinues next page VAGP-MED-01 V5.8 220121 Medical Clearance Guidelinespage 02 of 13

Effective 22 January 2021CODE/MEDICAL CONDITIONMEDICAL CLEARANCE REQUIRED COMMENTS(1C) Significant cardiac arrhythmiaNot required if the condition iscontrolled and stable(1D) Heart failure (congestivecardiac failure)Not required unless poorly controlled or * must be able to walk at least 50m andrequires oxygencarry out other Activities of Daily Living(ADLs) without discomfort orbreathlessness(1E) Cardiothoracic surgery - where Within 14 daysthe chest cavity is opened(1F) Cardiac angiography (Heart coronary artery X-rays)Within 3 days or if unstable(1G) Cardiac angioplasty with orwithout stent insertionWithin 3 days or if unstable(1H) DVT (Deep Vein Thrombosis) Within 21 days, provided stable on antior PE (Pulmonary Embolism). coagulants and asymptomaticAlso, significant predispositionto DVT/PE, including: Prior history of DVT/PE Significant family history Concurrent medical condition(e.g. fracture, injury, blooddisorder, cancer) or use ofmedication, whichpredisposes to DVT(1I) Pacemakers and internal(implanted) defibrillatorsWithin 72 hours of insertion or 24 hoursof replacement of device(1J) Ablation TherapyNot required if condition stable and nocomplicationsDoes not include arrhythmiasconsidered by the treating medicalpractitioner to be benignIn assessing fitness to fly, the treatingsurgeon must, in addition to any otherassessment, confirm there is nopneumothorax and indicate thisconfirmation on MED-01 Part 3A heart attack (myocardial infarction)within 21 days overrides theseprovisionsA heart attack (myocardial infarction)within 21 days overrides these provisionsAnti-coagulation stable (includes directfactor Xa inhibitors) or within therapeuticrange if applicable;normal respiratory functionCATEGORY 2 - BLOOD CONDITIONS(2A) Significant anaemia or bloodlossHb less 9.5g/dlIf acutely anaemic Hb level must beassessed at least 24 hours after lastknown blood loss and there must havebeen no further bleeding(2B) Sickle cell diseaseWithin 10 days of sickling crisisChronic disease MUST havesupplemental oxygen.Refer (10B) and flying with medicalconditions on special-needs-assistance/medicalconditionsCATEGORY 3 - RESPIRATORY CONDITIONS(3A) Pneumothorax (collapsedlung) occurring spontaneouslyor as a result of chest traumaWithin 10 daysLung expansion must be assessed bychest X-ray, providing evidence of no airin pleural space and must indicate thisconfirmation on VAGP-MED-01 Part 3.Continues next page VAGP-MED-01 V5.8 220121 Medical Clearance Guidelinespage 03 of 13

Effective 22 January 2021CODE/MEDICAL CONDITIONMEDICAL CLEARANCE REQUIRED COMMENTS(3B) Chronic lung diseases (COPD, Where supplemental oxygen is requiredemphysema, chronicduring the flight OR if unable to walkbronchitis)50m - at slow pace, withoutsupplemental oxygen OR recentexacerbation in last 7 daysSupplemental oxygen provisions mayalso apply. Refer (10B) and flying withmedical conditions on d delaying air travel wherethere has been a significantdeterioration within48 hours OR if there is cyanosis/highrespiratory rate(3C) AsthmaIf requiring ‘treater’ (bronchodilator)Must be stable with medication carried onmedication is required more frequently personthan 3 hourly OR recent deteriorationwithin 48 hours of travel;Recommend delaying air travel if recentsevere attack within last 48 hours(requiring hospitalisation)(3D) PneumoniaNot required if completely resolved (and Note: Contagious or infectious conditionsno requirement for oxygen)provisions may also apply. Refer (7A)(3E) TuberculosisUnacceptable to travel if received lessthan two weeks of treatment or ifproducing sputumFollow appropriate DOT treatment andaccording to WHO /WHO HTM TB 2008.399 eng.pdfCATEGORY 4 - NERVOUS SYSTEM AND PSYCHIATRIC CONDITIONS(4A) Stroke(cerebro-vascular accident)Within 7 days, must be stableMust be self-sufficient in regards toActivities of Daily Living (ADLs) andmobility otherwise nurse/carer escortrequired. If within 2 weeks of CVA shouldreceive supplemental oxygen (Refer to10B)(4B) Transient Ischaemic Attack(TIA)Within 3 days(4C) Epilepsy/Fitting/SeizuresNot required if stableRecommend no travel within 24 hoursfrom last seizureIn case of chronic seizure patterns,please contact the Guest ContactCentre(4D) Cranial surgeryWithin 14 daysAir travel should not occur if there isany residual air within the cranialcavity, and must indicate thisconfirmation onVAGP-MED-01 Part 3Continues next page VAGP-MED-01 V5.8 220121 Medical Clearance Guidelinespage 04 of 13

Effective 22 January 2021CODE/MEDICAL CONDITIONMEDICAL CLEARANCE REQUIRED COMMENTS(4E) Spinal surgeryWithin 5 days (for minor surgery)Within 10 days (for major surgery)Wound should be healing/dryNote: Passengers are required toremain seated at all times while the seatbelt sign is illuminated, consideration ofthe patients’ ability to tolerateunavoidable turbulence should betaken. Standard aircraft fitted life jacketsmay not fit passengers wearing a HALObrace - carriage of own device shouldbe taken(4F) Significant psychiatricconditionsNot required unless there has been asignificant deterioration orhospitalisation within 14 days* Thenature of such deterioration must bedetailed, along with response totreatment and date of last interventionrequired* The certifying medical practitionershould consider the possible stress oftravel on the individualNB: Not considered fit to fly if unstableOR likely to deteriorate duringflight/result in harm to crew/otherpassengers OR if sedated to the pointthat self-care is not possible OR ifcondition is likely to require activemedical intervention during the flight(4G) Head injury associated withloss of consciousness or skullfractureWithin 10 days of injury or seizureassociated with head injuryException (4C)No evidence of pnemocranium or currentCSF leak - must indicate thisconfirmation on MED-01Part 3.CATEGORY 5 - GASTRO-INTESTINAL CONDITIONS(5A) Acute infections such asRequired if symptomaticgastro-enteritis and Hepatitis ANB: Not considered fit to fly while thereis a risk of transmission to otherpassengers or crew (whether as aresult of active infection or possibleinfectious incubation)See also contagious or infectiouscondition. Refer (7A)(5B) Open abdominal surgery(e.g. tomy,Hepatectomy, Colectomy,Caesarean, RadicalProstatectomy)Within 5 days following surgeryOpen surgery means through a fullincision and not laparoscopic or 'keyhole'surgery(5C) Laparoscopic AbdominalSurgery (or 'keyhole' surgeryof the abdomen)Within 2 days of surgery or ifAll gas must be absorbed.complications occurred or within 5 daysif anastomosis was performed(5D) Diagnostic LaparoscopyNot required if uncomplicated(5E) Significantgastro-intestinal bleedingWithin 7 days, provided the bleedinghas stoppedNote: Blood Conditions: anaemia andblood loss criteria might also apply andwill override these provisions (refer tosection 2A)Continues next page VAGP-MED-01 V5.8 220121 Medical Clearance Guidelinespage 05 of 13

Effective 22 January 2021CODE/MEDICAL CONDITIONMEDICAL CLEARANCEREQUIREDCOMMENTSCATEGORY 6 - EYE, EAR, NOSE AND THROAT CONDITIONS(6A) Penetrating eye injury, retinaldetachment or hyphaema(bleeding into the front of theeye)Within 14 days and must be providedby an ophthalmologist (eye surgeon)Does not include removal of a foreignbody from the cornea.Any gas in globe must be reabsorbed(6B.1) Intraocular surgery WITHgasWithin 30 days and must be providedby the treating surgeon(ophthalmologist)Any gas injected into the globe must beabsorbed prior to travel(6B) Intraocularsurgery WITHOUTgas admixture (e.g. oil only)Within 10 days and must be providedby the treating surgeon(ophthalmologist)(6C) Cataract surgeryNot required if uncomplicated(6D) Corneal laser surgeryNot required if uncomplicated(6E) Severe otitis media (middle ear Not required if resolvedinfection)Must be able to clear ears(6F) Severe paranasal sinusitisNot required if resolvedMust be free of sinus pain or pressure(6G) Inner or middle ear surgeryWithin 10 days and must be providedby the treating ENT surgeon(Otolaryngologist)Includes the insertion of a cochlearimplantNot required for grommets(6H) Fractured jaw(surgically wired)Travel can be permitted without anescort or cutters, if quick self-releasewiring has been used(6I) Dental procedures(e.g. root canal, extractions,implants)Not required if greater than 24 hoursEnsure adequate analgesiaContinues next page VAGP-MED-01 V5.8 220121 Medical Clearance Guidelinespage 06 of 13

Effective 22 January 2021CODE/MEDICAL CONDITIONMEDICAL CLEARANCEREQUIREDCOMMENTSCATEGORY 7 - CONTAGIOUS OR INFECTIOUS CONDITIONS(7A) Includes, but is not confined to:Varicella ('chicken pox'),Herpes zoster ('shingles'),Hepatitis A, Gastroenteritis,Measles, Mumps, Rubella('German measles'),Pneumonia, Meningitis,Pertussis ('whooping cough'),Tuberculosis [TB])*Required if symptomaticNB: Not considered fit to fly while thereis a risk of transmission to otherpassengers or crew (whether as aresult of active infection or possibleinfectious incubation)(7B) COVID-19Required if symptomatic without recentnegative test result*The incubation period of the particularillness should be considered* If recent overseas travel or identified asa CLOSE contact: required 14-day selfquarantine must be completed ANDUnacceptable to travel:passenger must be asymptomatic prior to- if waiting for a COVID-19 test result to travel.return (not yet received the test result) If previous positive result: MUST beORasymptomatic PLUS at least 10 days- if symptomatic with positive test result have passed since the onset ofORsymptoms and there has been resolution- identified CLOSE contactof all symptoms of the acute illness forORthe previous 72 hours or two consecutive- symptomatic positive test if selfnegative test results.quarantine period has not beencompleted*For additional information, refer to yourlocal state/territory public healthguidelines.Note: vulnerable passengers arerecommended to discuss their travelplans with their treating physician prior toarranging travel to understandtransmission risks and preventativemeasures.Continues next page VAGP-MED-01 V5.8 220121 Medical Clearance Guidelinespage 07 of 13

Effective 22 January 2021CODE/MEDICAL CONDITIONMEDICAL CLEARANCE REQUIRED COMMENTSCATEGORY 8 - ORTHOPAEDICS(8A.1) Fractures - Upper LimbNot required if uncomplicatedNo requirement to split cast.Ensure adequate analgesia(8A.2) Fractures - Lower LimbNot required unless recent surgeryNB: If injury/surgery is 48 hours castneeds to be splitNote: Anaemia and DVT criteria mightalso apply and will overrule theseprovisions(8B) Arthroscopic joint surgeryNot required if uncomplicatedConsider mobility assistance(8C) Large joint replacementsurgery (hip, knee, shoulder)Within 5 days, or if complicationspersistConsider DVT prophylaxis. Mobilitycriteria may also apply and will overrulethese provisionsCATEGORY 9 - PREGNANCY AND NEWBORN(9A) PregnancyFlights greater than4 hours Any pregnancy with complicationswill require a medical clearance Within 5 days of normal vaginaldelivery (exclusion caesarean refer5B)Not acceptable to fly when: Single pregnancy - after the 36thweek Multiple pregnancy - after the 32ndweek Within 48 hours delivery (NormalVaginal Delivery (NVD))Risk of labour must be minimal.Note: After 28th week of pregnancy everypassenger must carry at all times, a letterdated no more than 10 days prior totravel from a doctor, or midwife outliningthe following: Estimated date of confinement Single or multiple pregnancy Absence of complications Fitness to fly for duration of flightbooked(9A.1) PregnancyFlights less than 4 hours Any pregnancy with complicationswill require a medical clearance Within 5 days of normal vaginaldelivery (exclusion caesarean refer5B)Not acceptable to fly when: Single pregnancy - after the 40thweek Multiple pregnancy - after the 36thweek Within 48 hours delivery (NormalVaginal Delivery (NVD))Risk of labour must be minimal.Note: After 28th week of pregnancy everypassenger must carry at all times, a letterdated no more than 10 days prior totravel from a doctor, or midwife outliningthe following: Estimated date of confinement Single or multiple pregnancy Absence of complications Fitness to fly for duration of flightbooked(9B) InfancyWithin 48 hours of birthRisk of hypoxia if respiratory system notyet fully developed(9C) Miscarriage (threatened orcomplete)Not required if fully recovered (nobleeding for 24 hours)Must be stable, no bleeding and no painfor at least 24 hoursContinues next page VAGP-MED-01 V5.8 220121 Medical Clearance Guidelinespage 08 of 13

Effective 22 January 2021CODE/MEDICAL CONDITIONMEDICAL CLEARANCE REQUIRED COMMENTSCATEGORY 10 - OTHER CONDITIONS AND PHYSIOLOGICAL STATES(10A) Anaesthetics - generalRefer to specific medical conditionsguidelines to determine fitness to travel.Should not fly within 24 hours followinga general anaesthetic(10B) Supplemental oxygenrequiredMedical clearance always required.Note: Other provisions might also applyPlease see additional information about depending upon the condition for whichoxygenoxygen is required. Refer to Flying withmedical conditions - SupplementaryOxygen on special-needs-assistance/medicalconditions(10C) Breast surgery (includingaugmentation or reductionprocedures)/Plastic surgeryof the superficial soft tissues,muscles and skinNot required unless complicationsEnsure adequate analgesia(10D) CAPD (ContinuousAmbulatory PeritonealDialysis)Not required if clinically stable andHb 9.5g/dl. Should travel withadditional CAPD fluid bags in case ofdelaysMust have doctor’s letter to present toairport security upon demand(10E) Anaphylaxis/allergies (severe, For passengers who believe they haveor even life-threatening)this condition but are not in possessionof appropriate medication for treatment,a letter or management plan from theirmedical practitioner will be required(10F) Scuba DivingPassengers must be at a low risk of areaction onboard.Virgin Australia cannot guarantee theairline environment or food will be free ofspecific allergens. If a passenger iscarrying an auto injector device (e.g.EpiPen), they must ensure it is in theircarry-on luggage and that they or anescort/carer/companion, are willing andcapable of administration if requiredNot required after 24 hours unlessrecent decompression sicknessNB: Air travel should not occur within24hours of last scuba dive(10G) Decompression sicknessWithin 4-7 days and must beasymptomaticMedical clearance MUST be provided bya specialist in hyperbaric medicineContinues next page VAGP-MED-01 V5.8 220121 Medical Clearance Guidelinespage 09 of 13

Effective 22 January 2021CODE/MEDICAL CONDITIONMEDICAL CLEARANCE REQUIRED COMMENTSCATEGORY 10 - OTHER CONDITIONS AND PHYSIOLOGICAL STATES(10H) Terminal or serious illness,not otherwise specifiedRequired in all casesOther provisions may also apply includinga medical escort/retrieval team(10I) Extensive burns or woundsConsider delaying travel where theConsideration should be given to woundswounds are extensive and might permit on pressure sensitive surfaces such asseepage of blood or tissue fluid during the buttocks, feet and backthe flight(10J) Transurethral Resection ofthe Prostate (TURP)Within 72 hours of procedure(10K) Thyroidectomy/HemithyroidectomyWithin 5 days of surgeryNOTE: AT TIME OF TRAVELIf a passenger presents physically ill (e.g. vomiting or requiring first aid oxygen) in the terminal area or whileboarding the aircraft, or presents other symptoms which create a reasonable concern that the passenger may notbe able to complete the flight safely, the passenger may be denied boarding and not be permitted to travel untilmedical clearance is obtained.VAGP-MED-01 V5.8 220121 Medical Clearance Guidelinespage 10 of 13

Effective 22 January 2021Part 3 - Medical Clearance Form1. PERSONAL INFORMATIONName/Title:Sex:MaleAge:Female2. TRAVEL INFORMATION (To be completed by the guest)Reservation Number(s)Flight Sector(s)DateFlight NumberTravelling FromTravelling To12343. MEDICAL CONDITION (To be completed by the treating doctor)CodeMedical conditionCodeMedical conditionCodeMedical conditionAdditional medical information (e.g. comorbidities, medications, vital signs):Date of diagnosis:Date: / /Date of any recent surgical operation:Date: / /NOTE: Codes 1E, 3A, 4DPlease confirm where indicated that an X-ray or other imaging has occurred to confirm that there is no air eitherin the pleural, mediastinum or cranial cavities:YesNoX-rayOther:If NO, the guest will be denied travel until medical confirmation is received.Is the passenger FREE from Contagious AND Communicable disease? YesNo(Specify)Continues next page VAGP-MED-01 V5.8 220121 Medical Clearance Guidelinespage 11 of 13

Effective 22 January 20214. ASSISTANCE REQUIREMENTSa) Wheelchair required?NoYesGate (WCHR)Door (WCHS)b) Is an escort required in flight to assist with eating, medications and toileting?c) Is a medically trained escort necessary?NoYesQualifications:Seat (WCHC)NoYesEscort Name:5. FACE MASK EXEMPTIONDoes the passenger have a physical or mental health condition, illness or disability that prevents them fromwearing a face mask?NoYes6. OXYGEN REQUIREMENTSAll oxygen and medical equipment requests must meet airlines requirements refer to In-flight pecial-needs-assistance/medical-conditions) otherwise must beapproved by Virgin Australia Engineering.1. Does your patient require oxygen during flight?(refer to Category 3 al-needsassistance/medical-conditions)2. If your patient requires oxygen, do they have the physical andcognitive ability to see, hear, understand, and take appropriateaction in response to the device’s aural and visual cautions andwarnings?3. Does your patient intend on using medical equipment onboard,please specify which is o(i) On the ground while at the airport?YesNo(ii) Onboard the aircraft?YesNo4. Specify the name and type of medical equipment requiredContinues next page VAGP-MED-01 V5.8 220121 Medical Clearance Guidelinespage 12 of 13

Effective 22 January 20217. DOCTOR'S DECLARATION (To be completed by the treating doctor)I have read and understood the Virgin Australia Medical Clearance Guidelines (VAGP-MED-01) and I certify thatthe above named passenger has been assessed by me as fit to travel on the nominated flights. I further certifythat this person does not have any contagious disease that could directly place another passenger or the crew atrisk, or that would contravene relevant Quarantine or Public Health Department regulations.I, (name of doctor) . hereby declare that to the best of my knowledge,(name of passenger) . is fit to travel.Doctor's SignatureDateDate Clearance Valid Until Qualifications/Provider Number:Practice Name/Hospital Name:Phone Number - Business Hours:After Hours:Address:Country:As a courtesy, Virgin Australia may notify any doctor who clears a passenger for travel if the condition of the passengerdeteriorates inflight, or if the level of care required for that passenger results in an interruption to normal operations.We are collecting your personal information. Please read our Privacy Statement – Virgin Australia (HealthInformation) and Privacy Policy located on our website for information about how we will handle thisinformation, our likely overseas disclosures and how you can access your personal information or make aprivacy complaint.8. PASSENGER DECLARATION (To be completed by passenger)I declare that the information contained on this Part 3 - Medical Clearance Form is accurate. I authorise VirginAustralia to use and release this information as required in the event of an emergency. I acknowledge that Airlinestaff are not medically trained and that the Airline cannot guarantee that I will receive appropriate medicalattention in any situation. I acknowledge that Virgin Australia reserves the right to refuse travel, notwithstandingcompletion of this form, if the Airline considers that it is not in my best interests to fly.Passenger's SignatureVAGP-MED-01 V5.8 220121 Medical Clearance GuidelinesDatepage 13 of 13

Use this form to determine if a passenger's medical condition makes them Unacceptable for Travel or if Medical Clearance required before travel. If Medical Clearance is required before travel, the Part 3 - Medical Clearance Form must be

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