Fit 2 Fly Medicals

Fit 2 Fly Medicals

Book your medical
Name*

First Name Last Name
E-mail address - important for confirmation of booking*
example@example.com
D.O.B*

DayMonth Year
Contact Phone Number*
Medical Type*
Please state if this is a Revalidation / Renewal / Initial / Recertification medical required*

Revalidate - this is if your medical expires in less than 45 daysRenewalInitial MedicalRecertificationOther
Pilot Number or CAA reference number: (Aviation Medical assessments only)
Medical expiry date (Aviation Medicals):

DayMonth Year
- We perform Aviation medicals, Private Hire medicals, and other Medicals on Tuesday 9.15am - 4.15pm, Wednesday 9.15am - 2.45pm, Thursday 9.15am - 4.15am.
Preferred Date*

DayMonth Year
Please note that your preferred date is not guaranteed, we will contact you for a confirmed date and also a time on or as near to your preferred date as possible.

If you do not have a preferred date, please leave the date field blank, we can contact you and offer you our available appointments.
Message / Details
Please let us know here if you would or would not like not like us to keep your details after your medical has taken place and/or if you would not like to receive reminder emails reminding you your medical is expiring.
Have you visited fit2fly (Aviation medicals) or Dr Wallis for a medical before?*

YesNo
For any help please do not hesitate to contact Katie on; Office: 01789 763060 option 5 or Mobile: 07436926286
Date

MonthDay Year
Date
Should be Empty: