Reservation Checklist for Persons With Disabilities

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A Step-by-step Guide for Planning Your Travel

Name
_______________________________________________________________________

Date of travel
_______________________________________________________________________

File/Locator no.
_______________________________________________________________________

Phone/E-mail
_______________________________________________________________________

Service provider (carrier)
_______________________________________________________________________

Advise carrier of the nature of your disability
Obtain written confirmation of services to be provided

Accessible Services for Persons with DisabilitiesDate 
Confirmed

1) Information in multiple formats on

itinerary
rates
disability-related services:
________________________________________________________other:
________________________________________________________

Multiple formats:

e-mail braille text only
 

2) Seating that meets your needs (except in emergency exit rows)

moveable aisle arm rest
moveable arm rest between seats
near entrance
additional leg room
near washroom
next to attendant
additional seating space
other:
________________________________________________________
 
3) Attendant(s)*
Is medical info required by carrier(s)? yesno
If yes, specify:
________________________________________________________
 
4) Carriage of a mobility aid*
Type:
________________________________________________________
Dimensions:
________________________________________________________
Type of batteries:
________________________________________________________
Special tools/instructions needed to disassemble/assemble:
________________________________________________________
Tools/instructions to be provided by: carrier traveller
 
5) Use of gaseous oxygen or portable oxygen concentrator on board and/or in terminals*
carrier-provided (fees may be applicable)
passenger-provided
assistance to/from washroom with oxygen

Is oxygen needed between flights/travel segments? yesno

 
6) Accessible ground transportation to/from terminal
taxi shuttle city bus between terminals other:
________________________________________________________
Are advance reservations for accessible ground transportation required?
yesno
 

7) "Unaccompanied-passenger" services (a higher level of assistance for individuals such as persons who have cognitive or intellectual disabilities)

Contact name:
________________________________________________________
Telephone number:
________________________________________________________
Services required in terminal(s) prior to departure, during connections, and/or upon arrival:
________________________________________________________
Services required on board:
________________________________________________________

 
8) Assistance with registration at check-in counter? yesno  
9) On departure, assistance to transfer from a passenger mobility aid*

at registration counter
at departure gate
between a mobility aid and a passenger seat
at aircraft/vehicle door

On arrival, assistance to transfer to a passenger mobility aid

between a passenger seat and a mobility aid
at aircraft/vehicle door
at arrival gate
at baggage carrousel*

Request electric cart or carrier-provided wheelchair? yesno

 
10) Assistance to get to the boarding gate/area? yesno
If yes, specify:
________________________________________________________
Assistance with short distances and stairs? yesno
 

11) Assistance to board/deboard? yesno

If yes, specify:

________________________________________________________

 
12) Assistance to store and retrieve carry-on baggage? yesno  
13) Is an on-board wheelchair available? yesno  
14) Is a tie-down available? yesno  

15) Meal-related services provided on-board

dietary requirements related to your disability
opening packages
identifying items
cutting large portions
 
16) Assistance to move to/from the onboard washroom (except by carrying)? yesno  
17) Assistance to get to a representative of another carrier in the same terminal? yesno

If yes, specify: ________________________________________________________

 
18) Assistance to retrieve checked baggage? yesno  
19) Assistance to get
to the general public area
to a service animal relief area
 
20) Carriage — free of charge — of a trained, certified and harnessed service animal at your seat

Size (height, width, length in a standing position):
________________________________________________________
Verify space for service animal at your seat
 
21) Carriage — free of charge — of your mobility aid (not counting towards checked baggage allowance)  
22) Carrier to issue a ticket to notify connecting carrier(s) of services to be provided  
23) Allergies

Type of allergies:
________________________________________________________

Accommodation required:
________________________________________________________

 

*There may be conditions or restrictions applicable to this service that should be discussed with your service provider.

For more information about the Agency, please contact:

Canadian Transportation Agency
Ottawa, ON  K1A 0N9

Telephone:
1-888-222-2592
TTY:
1-800-669-5575
Facsimile:
819-997-6727
E-mail:
info@otc-cta.gc.ca
Web site:
www.cta.gc.ca

Available in multiple formats.

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