Parents/Guardians seeking medical care assistance for their child must download this form
and have the child's doctor retype it on the doctor's letterhead. A copy of this document must be submitted to ICMF and the original must be handcarried with patient on airline(s). Questions? Email: ICMFHope@Aol.Com
TO WHOM IT MAY CONCERN:
Date: ____________ Patient's Name: ___________________________DOB: ____________
Patient's Address: ____________________________________________________________
I certify that I am the above referenced attending Physician since__________. I certify that ________________ is capable of flying and will not need any in-flight medical attention.
(Signature)