Medical Questionnaire Terms and Consent

Last updated: August 21, 2026

Please read these Medical Questionnaire Terms and Consent carefully before submitting this form.

1. Purpose of the Questionnaire

This medical questionnaire is used by EuropeCair to collect information necessary to:

Review the patient’s medical condition and transportation requirements;
Conduct a preliminary assessment of the patient’s suitability for air ambulance or medical transportation;
Determine the medical personnel, aircraft, equipment, medications, oxygen, ground transportation, and other services that may be required;
Prepare an estimate or proposal for medical transportation;
Coordinate services with medical professionals, hospitals, clinics, transportation providers, insurers, assistance companies, aircraft operators, and other parties involved in the requested transportation; and
Protect the health and safety of the patient, accompanying passengers, medical personnel, flight crew, and others involved in the transportation.

Submitting this questionnaire does not guarantee that EuropeCair will accept, arrange, or provide the requested transportation.

2. Accuracy and Completeness of Information

By submitting this questionnaire, you confirm that the information provided is accurate, complete, and current to the best of your knowledge.

You agree to disclose all information that may reasonably affect the patient’s transportation or medical care, including relevant diagnoses, symptoms, medications, allergies, infections, mobility limitations, oxygen requirements, behavioral conditions, pregnancy status, recent procedures, and changes in the patient’s condition.

You must notify EuropeCair promptly if the patient’s condition or any information supplied in this questionnaire changes before transportation occurs.

EuropeCair and the medical and aviation professionals involved may rely on the information provided when assessing and planning the transportation. Incomplete, inaccurate, or outdated information may result in delays, additional costs, changes to the proposed transportation plan, refusal or cancellation of transportation, or increased risk to the patient and others.

3. Authority to Submit Information

If you are completing this questionnaire for yourself, you confirm that you are legally capable of providing the information and granting the consents described below.

If you are completing it for another person, you confirm that:

You are the patient’s parent, legal guardian, authorized representative, healthcare proxy, or otherwise have lawful authority to provide the patient’s information and consent to its use;
The information you provide is accurate to the best of your knowledge; and
You will inform the patient, whenever reasonably possible, about the submission of this questionnaire and EuropeCair’s handling of their personal and medical information.

EuropeCair may request documentation confirming your authority to act for the patient.

4. Consent to Process Medical Information

Medical and health information is sensitive personal information.

By submitting this questionnaire, you explicitly consent to EuropeCair collecting, recording, reviewing, using, storing, and otherwise processing the personal and medical information provided for the purposes described in these Terms and in EuropeCair’s Privacy Notice.

This information may include:

The patient’s identity and contact information;
Medical history, diagnoses, symptoms, medications, allergies, and treatment information;
Physician, hospital, clinic, insurance, and emergency-contact information;
Mobility, accessibility, oxygen, infection-control, and medical-equipment requirements;
Copies of medical reports or other documents voluntarily supplied; and
Other information reasonably required to assess, arrange, or safely provide the requested transportation.
5. Disclosure to Service Providers and Medical Professionals

You authorize EuropeCair to disclose relevant personal and medical information, where reasonably necessary, to parties involved in reviewing, arranging, or providing the requested services. These parties may include:

EuropeCair employees and authorized representatives;
Physicians, nurses, paramedics, medical directors, and other healthcare professionals;
Hospitals, clinics, treating physicians, and receiving medical facilities;
Aircraft operators, flight crews, ground ambulance providers, and medical-escort providers;
Airports, ground-handling companies, and other operational service providers;
Insurers, assistance companies, case managers, and payment providers; and
Technology, communications, document-management, and data-hosting providers acting on EuropeCair’s behalf.

Only information reasonably necessary for the applicable assessment, quotation, coordination, safety, payment, or legal purpose should be disclosed.

6. International Processing and Transfers

Air ambulance and medical transportation services frequently involve multiple countries. As a result, personal and medical information may be accessed, processed, or transferred outside the country in which you or the patient resides.

Privacy and data-protection laws in those jurisdictions may differ from the laws in your home country. EuropeCair will take reasonable steps to protect personal information and use appropriate safeguards where required by applicable law.

Further information about international data transfers is available in EuropeCair’s Privacy Notice.

7. Preliminary Assessment Only

The questionnaire supports a preliminary medical and operational assessment. It is not a medical examination, diagnosis, treatment recommendation, medical prescription, or substitute for advice from a qualified healthcare professional.

Submission of the questionnaire does not establish a physician-patient relationship with EuropeCair or guarantee that transportation is medically appropriate or safe.

A final decision may require additional medical records, direct communication with treating professionals, a fit-to-fly certificate, medical clearance, an in-person assessment, or approval from the applicable medical director, aircraft operator, or receiving facility.

EuropeCair and the professionals involved may modify, postpone, decline, or cancel transportation if they determine that it cannot be performed safely, legally, or operationally.

8. Emergencies

This questionnaire is not monitored as an emergency medical communication service and should not be used to request immediate emergency assistance.

If the patient is experiencing a medical emergency, contact the local emergency services or an appropriate healthcare provider immediately. Do not delay emergency treatment while waiting for a response from EuropeCair.

9. Privacy and Security

EuropeCair will handle personal and medical information in accordance with applicable data-protection laws and its Privacy Notice.

Although EuropeCair uses reasonable administrative, technical, and organizational safeguards, no website, email transmission, or electronic storage system can be guaranteed to be completely secure.

For more information about how EuropeCair collects, uses, stores, shares, retains, and protects personal information—and how to exercise applicable privacy rights—please review the [EuropeCair Privacy Notice].

Privacy-related requests may be sent to info@europecair.com or to the privacy contact identified in the Privacy Notice.

10. Withdrawal of Consent

Where EuropeCair relies on consent to process medical information, you may withdraw that consent by contacting EuropeCair.

Withdrawal will not affect processing that was lawfully performed before the withdrawal. However, withdrawing consent may prevent EuropeCair from assessing, arranging, or providing the requested services where the relevant information is necessary for medical or operational safety.

Other legal grounds may permit or require EuropeCair to retain or process certain information, including compliance with legal obligations, the establishment or defense of legal claims, protection of vital interests, or performance of an agreement.

11. No Contract or Guarantee of Service

Submitting the questionnaire does not create a transportation agreement, membership agreement, insurance contract, guarantee of availability, or obligation for EuropeCair to provide or arrange services.

Any proposed service remains subject to medical approval, aircraft and crew availability, operational requirements, government authorization, airport access, weather, payment arrangements, and EuropeCair’s applicable service agreement.

12. Electronic Acceptance

Checking the acceptance box and submitting the questionnaire constitutes your electronic acknowledgment that:

You have read and understood these Medical Questionnaire Terms and Consent;
You have reviewed or had the opportunity to review EuropeCair’s Privacy Notice;
You confirm the accuracy and completeness of the information provided;
You have authority to provide the information, including information relating to another person where applicable; and
You explicitly consent to the collection, use, processing, and necessary disclosure of the personal and medical information as described above.

Your electronic acceptance will have the same effect as a handwritten acknowledgment to the extent permitted by applicable law.

13. Contact Information

Questions concerning this questionnaire may be directed to:

EuropeCair
Europecair Hellas
Ellinikis Dimokratias & A. Koumpi 24, 2nd Floor
Markopoulo 19003, Athens, Greece
Email: info@europecair.com
Telephone: +1 (862) 373-8478