Passenger Application

Below is a brief overview of our services and the link for the online application. Please access our application via the link below, and we will contact you once it has been received.

Mercy Medical Angels may sponsor a round-trip for a patient and one non-medical attendant (if the doctor finds it medically necessary) on a commercial flight, coach seating. The patient must be able to sit on their own accord once they are in the seat, require little or no medical attention, and they must be able to transfer out of their wheelchair into their seat on the aircraft with little or no assistance (they cannot have someone literally pick them up and sit them in the seat). If the patient requires oxygen some airlines may provide it during the flight or the patient must have a portable oxygen concentrator (POC) approved by the FAA or the airlines. The commercial airlines require no less than 48 hours advance notice, to prepare for the equipment needed. The patient would be responsible for making all arrangements and paying any fees associated with the oxygen needed to travel.

There may be a processing fee charged by the airlines for the tickets. If a fee is charged it can cost up to $12.00 per person, subject to change, which will be collected by credit or debit card prior to booking the flight. TSA FEES.

Tickets cannot be changed without penalty and we are not responsible for fees and increase in fares required for rescheduling of flights. We will also require a doctor’s note of explanation for the flight change.

Nonstop flights are not guaranteed.

All baggage fees are the responsibility of the patient.

We require a minimum of 21 days to consider flight assistance. We require the completion of a medical clearance form from the doctor who has recently physically seen the patient and knows they are going to this appointment. Our medical clearance form will be faxed to the doctor after we receive your application. We require income verification for the total household for everyone living in the home. Please forward current income tax 1040 form, disability and or SSI awards letters that state household income. Be sure to black out all social security numbers on your documents.

This is the link for our online application.

Passenger Application

We will contact the patient either by phone or email when I receive the application. At that time we will confirm the name of the doctor that will complete the medical clearance form. If you/the patient, do not hear from us within 2-3 business days after submitting the application; please follow up with us to make sure the application has been received.

As a reminder we require a minimum of 21 days to consider flight assistance. It is VERY important that you help in expediting any paperwork that needs to be forwarded to our office by following up with the doctor’s office or financial contact to avoid any delays in the process.

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