Special Assistance Request Form

Please fill in the Customer Information and the required Service information section below at least 48hours before flight departure.

Customer information

*mandatory field

Type of disabilities Customers with Walking Disabilities

Please input Booking reference in 6 characters before "/JL" indicated on your e-ticket.

Name on passport without any spaces or punctuations.
*If you have a Middle Name, please enter it after your Given Name.

Family name : Given name :

Either Tel or E-mail is required.
*Phone Number:(Country Code + area code + telephone number)
*Please provide phone numbers where you can be contacted during the day and at your destination(s).

Phone Number : E-mail :
Example: 762
Flight number :

Request details

Please select wheelchair assistance service.

Wheelchair assistance Service 1

You require assistance to/from the aircraft by your own wheelchair or airport wheelchair.

  • We will provide assistance between the Check-in counter and the gate.
  • We will give you the option to board the aircraft before other passengers.
  • We will assist you with the stowage of your baggage.

This page will open in a new windowMore information on service

If you need more assistance with stairs or moving around while onboard the aircraft, please select an alternate level of assistance.

Please confirm your wheelchair information below.

  • Size (WxDxH cm)
  • Weight (kg)
  • Collapsible or not
  • (If any) Type of battery if you have electric wheelchair (Nickel, Lithium, Lead, Gel or Silicon)
  • (If any) Gas spring type

  • Please confirm the assistance dog has been sufficiently trained.


Please type 「No other requests」If you don't have any additional requests.

Please also let us know on the day of departure how we can help.

Wheelchair assistance Service 2

You require assistance to/from the aircraft by your own wheelchair or airport wheelchair,
and assistance with stairs if the aircraft is parked away from the terminal.

  • We will provide assistance between the Check-in counter and the gate.
  • We will give you the option to board the aircraft before other passengers.
  • We will assist you with the stowage of your baggage.

This page will open in a new windowMore information on service

If you need more assistance with stairs or moving around while onboard the aircraft, please select an alternate level of assistance.

Please confirm your wheelchair information below.

  • Size (WxDxH cm)
  • Weight (kg)
  • Collapsible or not
  • (If any) Type of battery if you have electric wheelchair (Nickel, Lithium, Lead, Gel or Silicon)
  • (If any) Gas spring type

  • Please confirm the assistance dog has been sufficiently trained.


Please type 「No other requests」If you don't have any additional requests.

Please also let us know on the day of departure how we can help.

Wheelchair assistance Service 3

You require assistance to/from the aircraft by your own wheelchair or airport wheelchair,
you also need use of the onboard wheelchair to get to/from your seat and to move around the cabin during the flight.

  • We will provide assistance between the Check-in counter and the seat with your own or airport wheelchair and onboard wheelchair.
  • We will give you the option to board the aircraft before other passengers.
  • We will assist you with the stowage of your baggage.

This page will open in a new windowMore information on service

  • If you are travelling with an assistant who is able to lift you in and out of the onboard wheelchair.
  • If you are travelling by yourself, or with someone who is unable to lift you in and out of the onboard wheelchair, please contact us or fill in the box below.

Please confirm your wheelchair information below.

  • Size (WxDxH cm)
  • Weight (kg)
  • Collapsible or not
  • (If any) Type of battery if you have electric wheelchair (Nickel, Lithium, Lead, Gel or Silicon)
  • (If any) Gas spring type

  • Please confirm the assistance dog has been sufficiently trained.


Please type 「No other requests」If you don't have any additional requests.

Please also let us know on the day of departure how we can help.