Fit to Fly Letter in Canada
A fit-to-fly letter is a physician's written confirmation that you are medically cleared to travel by air on your planned dates. Airlines ask for one after recent surgery, in later pregnancy, for chronic conditions, and when you are flying with medication or medical equipment. Medinote issues fit-to-fly letters through its travel consultation — a flat $100 CAD, by phone, with the signed letter delivered travel-ready within 24 hours.
Content reviewed by licensed Canadian physicians. Last updated August 2026.
Included in the $100 consultation
- Phone consultation with a licensed Canadian physician
- Fit-to-fly / medical clearance letter where clinically appropriate
- Medication travel letter for security and customs
- Destination-specific travel health advice
- Signed PDF in your dashboard and inbox
The fit-to-fly letter is delivered through our travel consultation service — one appointment, one $100 fee.
What a Fit-to-Fly Letter Is
A fit-to-fly letter — the same document airlines call a medical clearance letter or a fit-to-travel letter — is a physician's signed statement that, following a medical assessment, there is no medical reason you should not fly on the dates you are travelling. It is written for a passenger, on physician letterhead, and it exists so a check-in agent or airline medical desk can see that a clinician has actually looked at your situation.
It is worth being precise about one thing: this is passenger documentation. It is not the aviation medical certificate that Transport Canada issues to pilots and cabin crew through Civil Aviation Medical Examiners, and no telehealth service can provide that. If you need medical certification to hold a flight crew licence, that goes through Transport Canada's own process.
Airlines set their own rules, and they differ. Before you book a consultation, check your carrier's published medical policy: what they require, whether it must be on their own form, and how close to departure the letter has to be dated. Bring that requirement to the appointment and the physician can address it directly.
When Airlines Ask for a Letter
The four situations that account for most requests — and what the physician can honestly do about each.
After Surgery
Airlines apply waiting periods after abdominal, chest, eye, and neurosurgical procedures, largely because of cabin pressure changes and trapped gas. The physician reviews the procedure, how far into recovery you are, your surgeon's advice, and your mobility, then decides whether clearance is reasonable. Bring your discharge summary and operative details. If your recovery is too recent or too complex to assess remotely, you will be told that instead of handed a letter.
During Pregnancy
Gestational cut-offs are set by each airline, not by any national rule — many ask for a physician's letter from around 28 weeks and restrict travel from roughly 36 weeks for a single pregnancy, with earlier limits for twins and different rules on long-haul routes. Check your carrier's policy first. The physician assesses whether air travel is suitable for you and confirms your stage of pregnancy and estimated due date; they cannot override an airline's cut-off, and a complicated pregnancy needs your own obstetric team.
Medication, Needles & Equipment
Carrying injectables, syringes, an EpiPen, insulin, liquids above the usual limit, or prescription medication across a border is far smoother with a physician's letter confirming the medication is prescribed to you and medically necessary. That medication travel letter comes out of the same consultation. Portable oxygen concentrators are the exception — airlines run their own approval process and usually their own form, so start with the airline.
Chronic Conditions & Entry Rules
Stable heart, lung, and other chronic conditions often prompt a clearance request, particularly on long-haul flights. Travel insurers and some destinations also ask for medical documentation. The physician assesses your current status and can document stability and recommended precautions — and will say so if your condition needs specialist input before you fly.
What the Letter Contains
Your identifying details
Name and date of birth, matching your travel documents.
Assessment and travel dates
The date of the medical assessment and the travel period the clearance covers.
A clear statement of fitness
That, based on the assessment, there is no medical reason you should not travel by air.
Medication and equipment details
Where relevant and with your consent — enough for security and customs, not your full record.
Physician credentials
Name, licence number, signature, and contact details on medinote letterhead so the airline can verify it.
Travel Consultation
- Phone consultation with a licensed physician
- Fit-to-fly letter where clinically appropriate
- Medication travel letter
- Destination-specific health advice
- Travel-ready documentation within 24 hours
- Signed PDF in your dashboard and inbox
If your airline requires its own form completed instead of a letter, that is a third-party form — priced from $150, with the exact price shown at booking.
How to Get Your Letter in 3 Steps
Book 1–2 weeks before departure where possible — some airlines want the letter dated within a set window before the flight.
Check Your Airline’s Rule
Find out whether they want a letter or their own form, and by when. Bring it to the call.
Book a Travel Consultation
Choose the travel consultation at medinote.ca/book — $100 CAD, phone only, no app.
Receive Your Signed Letter
The physician assesses your fitness to fly and the letter is travel-ready within 24 hours.
What a Remote Consultation Cannot Do
A fit-to-fly letter is a clinical judgement, not a formality. Here is what falls outside it — the physician will tell you during the call if your situation does.
- Clear every condition. Some situations — very recent major surgery, unstable cardiac or respiratory disease, a complicated pregnancy — need an in-person assessment or specialist opinion before anyone can responsibly sign.
- Override an airline’s policy. Gestational cut-offs, post-operative waiting periods, and equipment approvals belong to the carrier; a physician’s letter cannot waive them.
- Replace a Transport Canada aviation medical certificate. Pilots and cabin crew are certified by Civil Aviation Medical Examiners through Transport Canada, not by telehealth.
- Perform physical examinations, imaging, or lab work — assessments are by phone.
- Complete an airline’s own medical form as part of this service. Third-party forms go through the medical forms service, priced from $150 with the exact price shown at booking.
- Prescribe controlled substances (opioids, benzodiazepines, stimulants), including for travel.
- Handle emergencies, or serve the territories — medinote operates in the 10 provinces. For anything life-threatening, call 911.
Frequently Asked Questions
What is a fit-to-fly letter?
A fit-to-fly letter — also called a medical clearance letter or fit-to-travel letter — is a signed statement from a physician confirming that, based on a medical assessment, there is no medical reason you should not travel by air on your planned dates. Airlines commonly ask for one after recent surgery, during later pregnancy, for chronic conditions, or when you are travelling with medical equipment or injectable medication. It is a passenger document; it is not the aviation medical certificate that Transport Canada requires of pilots and cabin crew.
How much does a fit-to-fly letter cost in Canada?
A fit-to-fly letter is issued through medinote’s travel consultation, which is a flat $100 CAD. That covers the phone consultation with a licensed Canadian physician, the signed letter, and any travel health advice or medication travel letter that comes out of the same appointment. There is no separate charge for the letter itself.
How quickly can I get one?
Same day in most cases — travel documentation is prepared and delivered to your dashboard and email within 24 hours of the consultation. Book 1–2 weeks before departure where you can, because some airlines want the letter dated within a set window before the flight and a few require their own form returned in advance. Urgent requests are accommodated where physician availability allows.
Can I get a fit-to-fly letter after surgery?
Often, but not automatically. Airlines apply their own waiting periods after abdominal, chest, eye, and neurosurgical procedures, and the physician has to assess whether flying is reasonable for your specific recovery. Bring your operative details, discharge summary, and your surgeon’s advice to the consultation. If your recovery is too recent or too complex to clear remotely, the physician will tell you that rather than sign a letter they cannot stand behind.
Do I need a doctor’s letter to fly while pregnant?
Most airlines require one in the later stages of pregnancy, and the exact cut-off varies by carrier — some ask for a letter from around 28 weeks, many restrict travel from roughly 36 weeks for a single pregnancy and earlier for multiples, and the rules differ again for long-haul flights. Check your airline’s published policy first, then book. The physician assesses whether air travel is suitable for you and confirms your estimated due date and stage of pregnancy in the letter; they cannot override an airline’s policy or clear a complicated pregnancy remotely.
Can I get a letter for travelling with medication, needles, or an oxygen concentrator?
Yes — a medication travel letter is part of the same $100 travel consultation. It confirms that the medication is prescribed to you and is medically necessary, which is what airport security and customs officers ask for when you carry injectables, syringes, liquids over the usual limit, or controlled medication in your hand luggage. Portable oxygen concentrators are different: airlines require their own approval process and often their own form, so start with your airline and bring their requirements to the consultation.
What does the letter actually contain?
Your name and date of birth, the date of the medical assessment, a statement of fitness for air travel covering your travel dates, any relevant condition or medication details you consent to disclose, any recommended precautions, and the physician’s name, licence number, signature, and contact details on medinote letterhead. Only what the airline needs is included — the letter is not a copy of your medical record.
What if my airline has its own form?
Some carriers require their own medical information form (often a MEDIF or similar) completed and signed by a physician instead of, or in addition to, a letter. Third-party forms with their own template are handled through our medical forms service rather than the travel consultation — those are priced per form from $150, with the exact price shown at booking. Upload the form when you book so the physician can review it before your call.
Flying Soon and Need Clearance?
Book a travel consultation with a licensed Canadian physician. Fit-to-fly letter, medication travel letter, and destination advice — travel-ready within 24 hours.
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