# Reservation Checklist

A step-by-step guide for planning your travel

From the: Canadian Transportation Agency

Available in multiple formats

Name. (specify).

Date of travel. (specify).

File/Locator number. (specify).

Phone/E-mail. (specify).

Service provider (carrier). (specify).

Check box; Advise carrier of the nature of your disability.

Check box; Obtain written confirmation of services to be provided

Reader’s note.

Presentation of a table. The table has 2 columns. The left one is entitled : “Accessible Services for Persons with Disabilities” and the second one : “Date confirmed”. Each row of the second columns has a blank space to fill and won’t be mentioned further.

End of reader’s note.

# Accessible Services for Persons with Disabilities.

## Row 1) Information in multiple formats on.

· Check box: itinerary,

· Rates,

· disability-related services (specify), or

· other (specify).

Multiple formats

Chose between:

· e-mail,

· braille, or

· text only.

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

Reader’s note.

All following items have check box for selection.

End of reader’s note.

· moveable aisle arm rest,

· moveable arm rest between seats,

· near entrance,

· additional leg room,

· near washroom,

· next to attendant,

· additional seating space, or

· other (specify).

# Row 3) Attendant(s).

Note.

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

End of note.

Is medical info required by carrier(s)?

Check box yes or no.

If yes, specify.

## Row 4) Carriage of a mobility aid.

Note.

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

End of note.

· Type (specify),

· Dimensions (specify),

· Type of batteries (specify,)

· Special tools/instructions needed to disassemble/assemble (specify).

Tools/instructions to be provided by

· Check box carrier, or

· Traveller.

# Row 5) Use of gaseous oxygen or portable oxygen concentrator on board and/or in terminals.

Note.

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

End of note.

· Check box; carrier-provided (fees may be applicable),

· passenger-provided, or

· assistance to/from washroom with oxygen.

Is oxygen needed between flights/travel segments?

Check box yes or no.

## Row 6) Accessible ground transportation to/from terminal

· Check box; taxi,

· Shuttle,

· city bus,

· between terminals, or

· other (specify).

Are advance reservations for accessible ground transportation required?

Check box yes or no.

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

· Contact name (specify).

· Telephone number (specify).

· Services required in terminal(s) prior to departure, during connections, and/or upon arrival (specify).

· Services required on board (specify).

## Row 8) Assistance with registration at check-in counter?

Check box yes or no.

## Row 9) On departure, assistance to transfer from a passenger mobility aid.

Note.

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

End of note.

· Check box: at registration counter,

· at departure gate,

· between a mobility aid and a passenger seat, or

· at aircraft/vehicle door.

On arrival, assistance to transfer to a passenger mobility aid

· Check box: between a passenger seat and a mobility aid,

· at aircraft/vehicle door,

· at arrival gate, or

· at baggage carrousel.

Note.

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

End of note.

Request electric cart or carrier-provided wheelchair?

Check box yes or no.

## Row 10) Assistance to get to the boarding gate/area?

Check box yes or no.

If yes, specify.

Assistance with short distances and stairs?

Check box yes or no.

## Row 11) Assistance to board/deboard?

Check box yes or no.

If yes, specify

## Row 12) Assistance to store and retrieve carry-on baggage?

Check box yes or no.

## Row 13) Is an on-board wheelchair available?

Check box yes or no.

## Row 14) Is a tie-down available?

Check box yes or no.

## Row 15) Meal-related services provided on-board.

· Check box: dietary requirements related to your disability,

· opening packages,

· identifying items, or

· cutting large portions.

## Row 16) Assistance to move to/from the onboard washroom (except by carrying)?

Check box yes or no.

## Row 17) Assistance to get to a representative of another carrier in the same terminal?

Check box yes or no.

If yes, specify.

## Row 18) Assistance to retrieve checked baggage?

Check box yes or no.

## Row 19) Assistance to get.

· Check box: to the general public area, or

· to a service animal relief area.

## Row 20) Carriage - free of charge - of a trained, certified and harnessed service animal at your seat.

Specify size (height, width, length in a standing position).

Verify space for service animal at your seat.

## Row 21) Carriage - free of charge - of your mobility aid (not counting towards checked baggage allowance).

## Row 22) Carrier to issue a ticket to notify connecting carrier(s) of services to be provided.

## Row 23) Allergies.

· Type of allergies (specify).

· Accommodation required (specify).

End of Table.

# Contact Information:

Canadian Transportation Agency

Ottawa Ontario K1A 0N9

Tel.: 1-888-222-2592

Fax: 819-997-6727

TTY: 1-800-669-5575

E-mail: info@otc-cta.gc.ca

Web site: www.cta.gc.ca