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Disability Assistance Request

Request For Disability Assistance on a Current Reservation
* Indicates a Required Field
Type(s) of assistance needed: *
Connection assistance for customers with mental disability
Portable oxygen concentrators
Service animal
Wheelchair
Other special assistance needs
If "Other" please describe needs:
Your Contact Information
*
*
*
Suffix:
Int'l
Code
Area/City
Code
Number Ext.
- -
- -
- -
Flight Information
Date of Travel: *
Flight Number: *
PNR Record Locator: *
Optional Comments