At a glance
| What you get | The airline's medical form completed by the doctor, or a letter, after an examination. |
|---|---|
| Who decides | The airline. The doctor reports what he or she finds. |
| Common form | The Medical Information Form, or MEDIF. SAA publishes its own version. |
| Where | Wherever you are recovering, from a hotel room to a family home, within our list of Cape Town areas. |
| Fee | Given by the doctor during the first phone call, before you agree to the visit. |
| Emergencies | Outside our scope. Ambulance: 10177, or 112 when calling from a cell phone. |
What a fit-to-fly certificate is
It is a doctor's statement, written on the airline's own form or as a letter, describing your condition and whether you are fit to travel by air. The airline reads it and decides. The doctor cannot decide for the airline.
Illness or injury on a trip to Cape Town can turn a booked flight home into a question mark. An operation, a hospital stay, a bad chest infection or a fracture can all lead an airline to ask for medical clearance before you board. What the airline wants, and by when, is set by the airline.
South African Airways says so on its own form: SAA's medical form states that the airline reserves the right to accept or decline your application. Other airlines have their own forms and their own rules. We do not repeat them here, because they differ from one carrier to the next and they change. Ask your airline's special assistance or medical desk exactly which document it needs and the deadline for sending it.
The MEDIF, explained
MEDIF stands for Medical Information Form. On the SAA version, you fill in your own details and your flight, and the treating doctor completes the medical part, including his or her practice number.
The SAA form, dated May 2024, asks for a MEDIF when a passenger has a complicated chronic illness or a recent illness, injury, surgery or hospital stay. It also covers passengers who need special services on board, such as oxygen, a stretcher, a medical escort or medical equipment. Travellers who were operated on or admitted to hospital within the previous two weeks have to book through SAA Special Bookings, and the doctor must state whether they have recovered completely and whether their condition has stabilised enough for a commercial flight.
SAA's guidance for doctors gives the reason. The cabin is pressurised to the equivalent of an altitude of 6,000 to 8,000 feet, the pressure of oxygen is about 20% lower than on the ground, and gas inside the body expands and contracts as cabin pressure changes, which can cause pain. A condition that is comfortable at sea level in Cape Town may behave differently at cruising height, and that is what the doctor is asked to judge.
The same form covers pregnancy. Beyond 28 weeks, SAA asks for a letter from an obstetrician, general practitioner or midwife stating, among other points, how far along the pregnancy is and whether the passenger is fit to travel.
Timing matters. SAA's form says the completed form "must be emailed to SAA Special bookings within 48hr of your proposed flight". Deadline wording like this can be read more than one way, so check it with the airline if it is unclear, and do not leave the doctor's visit until the last day.
The practice number box
Section 3 of the SAA MEDIF asks for the treating physician's name, qualifications, speciality and "PR" number. That box is for the practice number given out by the Board of Healthcare Funders through its Practice Code Number System, which independent practitioners in South Africa use on their official documents. Our doctors write in their own practice number, along with their contact details, so the airline can reach the doctor who examined you if it has a question.
What happens at the visit
The doctor asks about the illness, injury or operation behind the airline's request, reads any hospital papers you have, examines you, and completes the form only if he or she can honestly do so.
- Ask for a doctor on WhatsApp or with the request form, naming the airline and your flight date.
- The doctor who accepts phones you, introduces himself or herself with an HPCSA registration number, states the fee and settles a time with you.
- Before the visit, download your airline's form if it has one and gather your booking reference, any discharge papers or reports from a hospital that treated you, and the medicines you are taking.
- During the visit the doctor hears the full story, examines you and works through the airline's questions with you.
- If the examination supports it, the doctor signs the form or letter. Either way, you receive an itemised invoice.
Check with your airline who sends the completed form and where. On the SAA version it goes by email to SAA Special Bookings. Keep a copy for yourself and for your travel insurer.
If the doctor finds you are not fit to fly yet
The doctor will say so and explain why. A certificate reflects what the doctor finds at the examination, and it is never issued simply because a flight is booked.
That is hard news with a flight a few days away. The doctor can tell you what would need to change before flying is reasonable and whether a second examination later makes sense. A written note of the reasons will help when you talk to your airline about rebooking. If your travel insurance covers changes for medical reasons, ask the doctor for a medical certificate stating why you could not travel on the original date.
When to ask
Ask as soon as the airline tells you it needs medical clearance. The visit is booked for a time you agree with the doctor, and we do not promise a fixed turnaround for the paperwork.
If your flight leaves from Cape Town soon, start now. How long it takes depends on your situation: a short visit for a stable condition, or a longer one if hospital records need to be read first. Starting early leaves room for a second visit, or for the airline to ask follow-up questions, before the deadline on its form.
Fees and invoice
Prices are not listed here. The doctor names the fee during the first call, and payment goes to the doctor, never through this website.
Ask for the invoice and the completed form at the same time. Both carry the doctor's practice number, which makes them easier to use if you claim the cost of the visit, or of a changed flight, from travel insurance. Whether a policy pays for either is up to the insurer. Our home and hotel doctor page explains the fee rules in more detail.
Emergencies
SA Home Doctor is not an emergency service. If your condition worsens while you wait to fly, with chest pain, breathlessness or fainting, phone 10177, or 112 from a mobile, straight away.
State hospitals in Cape Town, with the hours the provincial government publishes for them:
- Victoria Hospital, Wynberg (government, 24 h)
- Tygerberg Hospital (government, 24 h)
- New Somerset Hospital, Green Point (government, 24 h)
- Groote Schuur Hospital, Observatory (government, 24 h)
Frequently Asked Questions
Is there an official fit-to-fly certificate in South Africa?
Each airline sets its own requirements. SAA, for example, uses a Medical Information Form, or MEDIF, completed by the treating doctor. Ask your airline which form it wants.
Can the doctor fill in my airline's MEDIF?
Yes, if the doctor examines you and can honestly complete it. Have your airline's form ready, and the doctor fills in the medical part, including his or her practice number.
Does a certificate mean the airline must let me fly?
No. The airline decides. SAA's form states that the airline reserves the right to accept or decline an application.
How soon before my flight should I ask?
As soon as the airline tells you it needs medical clearance. Check the deadline on your airline's form and agree a visit time with the doctor well before it.
What if the doctor says I am not fit to fly?
The doctor explains why and what would need to change. You can then discuss rebooking with your airline and, if relevant, your travel insurer.
How much does a fit-to-fly visit cost?
No fee is listed on this site. You hear it from the doctor on the first call, and you pay him or her directly.
What if I get worse before my flight?
If it is an emergency, such as chest pain, breathlessness or fainting, phone 10177, or 112 from a mobile. SA Home Doctor is not an emergency service. Otherwise tell the doctor, and the airline, before you travel.