Fit to Fly in Pregnancy Form

 

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Please complete the below form to inform the practice that you require a Fit to Fly in Pregnancy Letter.

As this is a private service, a fee of £35 +VAT is payable to the practice on collection. Payment can be made by cash or card, or an online payment link can be texted to you in advance of collection.

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Personal Details
Please double check you've entered the correct email address
May be used to identify you
Pregnancy Details
If yes, please describe
Flight Details
Number of weeks pregnant
Number of weeks pregnant
What to do next
  • You must now bring your maternity notes to Gloucester Road Medical Centre so that the form or letter can be completed by your GP.
  • If your airline has its own ‘fit to fly’ form you must also bring this to reception.
  • We will let you know when your completed letter and maternity notes are ready to collect.
  • Fee for letter must be paid at time of collection

Privacy Consent

This form collects personal and medical information about you. We use this information to allow the practice team to contact you. Please read our Privacy Policy to discover how we protect and manage your submitted data.

 
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