signature test

This form must be filled out and submitted immediately.


(*) Indicates the field is required


(Given in degrees LAT and LONG)

Details of Affected Passenger


Details of Relatives/Friends Accompanying the Passenger


If medical help was provided on board by a Doctor, Nurse or Paramedic

Drop your file here or click here to upload You can upload up to 10 files.
Drop your file here or click here to upload You can upload up to 10 files.