Specific service request form

Please complete this option if you require assistance for blind or low vision and did not add a request when making your booking.

Please also read our information about travelling with an assistance animal.

Please complete this option if you are deaf or hard of hearing and did not add a request when making your booking.

Please also read our information about travelling with an assistance animal.

Please complete this option if you require assistance and did not add a request when making your booking.

Please also read our information about travelling with an assistance animal.

Please complete this option if you require wheelchair assistance and did not add a request when making your booking. If you are immobile, you may require assistance when travelling. Please refer to our independent travel criteria.

If you are travelling with a carer or require an assistance person, please complete the section travelling with a carer or providing an assistance person.

Please also read our information about size and weight requirements for mobility aids and medical conditions.

Please complete this section if you are travelling with a carer to assist in flight, or will be travelling with an assistance person to help with transferring to or from your seat. Please also read our information on mobility assistance.

Please complete this section if you have a medical condition that may require medical clearance. Please also read our information regarding specific medical needs and Medical Clearance Guidelines (PDF 324KB) as you may be required to supply further information or to complete a Medical Clearance form (available as part of the Medical Clearance Guidelines (PDF 324KB) and present it at check-in.

Please complete this option if you require assistance for disabilities such as autism, dementia, psychological disabilities or mental illness that may not be immediately obvious to Virgin Australia team members.

If you are travelling with powered, battery operated or other medical equipment or assistive devices for use onboard, please refer to the Virgin Australia medical equipment section to ensure your equipment is suitable for travel. If your device is not listed as an approved device, please complete the Personal Medical Equipment form at least 48 hours prior to departure date and submit below or via email to VA.Medical@virginaustralia.com or Fax: +61 7 3295 3100

Please also read our information about travelling with medical conditions and about travelling with medical equipment. Medical conditions requiring the use of a portable oxygen concentrator (POC) require a Medical Clearance form to be completed and submitted for approval at least 48 hours prior to departure date.

If you have completed a Personal Medical Equipment form, please attach it before submitting your request.

If you require any other assistance or have any additional information in regard to this request, such as the following, please include it here:

• Specific seating requirements for a disability or injury (e.g. to accommodate a leg fracture or fused knee cap)
• Need a removable arm rest