30 day grace

United HealthCare Community CMN West

Posted: 2018-01-13 21:22

Your patient desires to use a Portable Oxygen Concentrator on board a United aircraft for upcoming travel. In accordance with Federal Aviation Regulations, United requires a physician’s verification of the customer’s medical need to use this device while traveling on a commercial aircraft. Accordingly, please answer the questions below. After you have completed and signed this form, please return to your patient as this form must be in his or her possession and available for inspection on the day of travel.

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