请求轮椅或护送协助

此表格仅提供英文版本，请用英文填写。

You may use the form below to request wheelchair assistance or escort assistance for blind or visually impaired customers on incoming flights.

Please make sure to send this form at least 48 hours prior to departure. However, we will make every effort to accommodate requests made within that time frame.

If travel is urgent within 48 hours, please call our Medical Desk:

1 800 667-4732 (Toll-free between Canada and the United States)
1 514 369-7039 (long distance charges apply)
Monday to Friday: 6 a.m. to 8 p.m. (Eastern Time)
Saturday and Sunday: 6 a.m. to 6 p.m. (Eastern Time)

Assistance required Assistance required

Please select the type of assistance you’ll require for your travel. Select an option and it will expand to show additional information and instructions:

Wheelchair assistance

Learn more about our wheelchair assistance services.

Select the option below that fits best your situation: Please select a type of assistance you require from the drop-down menu.

Travelling with your own wheelchair

Type of wheelchair: Please select Type of wheelchair you require from the drop-down menu.

Please print and complete two copies of our Powered Mobility Aid Information Form Opens PDF file and bring them with you to the airport. You may also request a form at the airport and complete it there.
View special handling requirements as they apply to battery-powered mobility aids such as wheelchairs and scooters.

Wheelchairs/Scooter details:

Lbs / In

Kg / Cm

Weight Please enter the wheelchair or scooter weight. Only numric characters (0 - 9) are accepted.

Height Please enter the wheelchair or scooter height. Only numric characters (0 - 9) are accepted.

Width Please enter the wheelchair or scooter width. Only numric characters (0 - 9) are accepted.

Battery Type Please select a battery type from the drop-down menu.

Seating accommodations

Learn more about seating accommdations.

type Accomodation Please select a accomodation type from the drop-down menu.

Please specify: Please enter the type of accomodations, not on the list, that will you need.

IMPORTANT: An Air Canada agent will need to contact you to confirm your request and see how it can be best accommodated. Please make sure to correctly eneter your contact information.

Escort assistance for blind or visually impaired customers

Learn more about our services for visually and hearing impaired customers.

What type of accomodation will you need? Please select a accomodation type from the drop-down menu.

Travelling with a portable battery-powered medical device

Learn more about travelling with portable battery-powered medical devices.

Note, this section does not apply to wheelchairs or other battery-powered mobility aids. Please indicate a brief description or web link for additional information about your medical device.

Medical Device Please indicate a brief description or web link for additional information about your medical device.

Battery Type Please select battery Type from the drop-down menu.

Stowing and retrieving a mobility aid other than a wheelchair

When possible an Air Canada agent will help stowsmall mobility aids in the cabin such as braces, canes, crutches and walkers.Please specify below which mobility aid you will be travelling with.

Mobility Aid Please specify which mobility aid you will be travelling with.

Personal information

Title Please select a title from the drop-down menu.

Please enter a first name, comprised of at least 2 valid characters. Only alphabetic characters (A to Z), apostrophes ( ' ), dashes ( - ) and spaces are accepted.

Please enter a Last Name, comprised of at least 2 valid characters. Only alphabetic characters (A to Z), apostrophes ( ' ), dashes ( - ) and spaces are accepted.

Please enter a valid email address format, with:

a maximum of 60 characters
only one "@" sign
only valid characters: 0 to 9; A to Z; dot (.); hyphen (-); underscore ( _ )
no consecutive dots (..)

This field accepts only numeric characters (0 - 9).

Booking Information Please select a reference from the drop-down menu.

Please enter a Booking Reference Number, comprised of 6 valid characters. Only alphanumeric characters (A to Z, 0 to 9) without spaces are accepted.

Please enter a Ticket Number starting by 014 and followed by 10 digits. Only numeric characters (0 to 9) are accepted.

Please enter an Air Canada Flight Number starting by AC/QK followed by upto 4 numeric characters (0 to 9).

Please enter a departure date.

{{trip.departure | date : 'EEE'}} {{trip.departure | date: 'dd MMM'}} Date

Additional information

Please enter any additional information that could help us understand your needs. * Optional

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