Air Canada Transportation Program - Jim Pattison Children's Hospital Foundation

The Air Canada Foundation works with Jim Pattison Children’s Hospital Foundation to give families access to vital medical treatments in centers unavailable in Saskatchewan. The Hospital Transportation Program offers financial peace of mind to those who must travel due to a child’s hospitalization.

Air Canada Transport Form

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"*" indicates required fields

Child's Name*

Child's Date of Birth*

Gender*

Male

Female

Parent(s) name(s)*

Parent(s) Date of Birth*

Address*

Street Address Address Line 2 City Postal Code

Home Phone

Work Phone

Cell Phone

Email Address*

Medical Information

Brief description of child's illness*

Name of child's specialist

Specialist's phone number

Name of child's family doctor

Family doctor's phone number

Documentation*

Please attach written documentation from the child’s specialist and/or family doctor explaining why out-of-province travel is necessary (see #2 of Policy Guidelines).

Accepted file types: doc, docx, pdf, jpg, png, pages, Max. file size: 100 MB.

Travel Information

Please specify the medical appointment/surgery date*

Please specify the desired departure date*

From which city*

To which city*

Please specify the desired return date*

Name of accompanying adult for air travel

Does the child or adult need any special travel arrangements (e.g. oxygen, wheelchair, special meals? If so, please specify

Policy Guidelines

This program is for out-of-province medical travel for one child (18 years old or under) and one accompanying adult or two adults if the child is under the age of 2 upon the booked departure date.

The applicants must be residents of Saskatchewan.

The family must complete and return the application before the flight can be booked.
We recommend requesting flights at least 10 days prior to the desired departure date, but understand that urgent situations do occur. The application must be complete particularly detailing any special requirements for Air Canada – e.g. oxygen, wheelchair, meals etc.
Along with the application, the family must provide written documentation from their specialist and/or pediatrician/family doctor explaining why out-of-province travel is required, before any arrangements can be made.
Each application will be considered based upon urgency and need, with each application being reviewed on a “case by case” basis.
Travel arrangements will be dependent upon availability with Air Canada.
The family will need to supply JPCHF and Air Canada (departing and returning) with a medical note from the child’s doctor indicating that it is safe for the child to travel via plane and that should any complications arise from the air travel, Air Canada is in no way liable for those.
The family must be able to produce the appropriate travel documents as required by federal government regulations including photo identification, birth certificates, and legal documents pertaining to custody arrangements. Failure to provide these documents will result in rejection of the application.
After approval of one trip for a family, JPCHF will consider follow-up visits in future, should it be required. These subsequent trips are in no way guaranteed but will be considered amongst other applications.
After returning from medical out-of-province treatment using JPCHF and Air Canada Foundation Hospital Transportation Program, the family should be amenable to publicly thanking and/or acknowledging the two organizations for their assistance and contribution, if requested.

If you need further information please contact info@pattisonchildrens.ca

This application will be reviewed and approved through the Senior Leadership Team and/or Board of Directors of JPCHF on a case by case basis.

Hospital Transportation Program

Air Canada Transport Form

Medical Information

Travel Information

Policy Guidelines

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