Medical Waiver Request Form
If you have purchased travel insurance from hawaiianair.com, please contact Travel Guard to file a medical claim at 1-866-360-1959. If you have purchased any other travel insurance, please contact the respective company to file a claim.
Our Consumer Affairs Office will respond to you within 30 business days. All requests will be handled in the order received.
Please click on the link below to download the medical form. A signature of the attending physician is required on the form.
Medical Waiver Form (PDF)
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If you are unable to download the form, please call 1-888-246-8526 Monday-Friday from 8:00 a.m.-4:30 p.m. HST, and we will be able to send you the form. You may also request a form by emailing Consumer Affairs. You may send or fax completed forms to:
PO Box 30008
Honolulu, HI 96820