Bookings If you have an account, please login before completing this form. You will be redirected to the booking page after login. Register Login Booking Details Please accept our Booking Terms & Conditions This form is for a single trip booking only, multi-leg journeys will have to be booked individually. Bookings are only final when you receive an email to confirm your booking. A 50% cancellation fee applies when less than 24 hour notice is given to cancel. There is no penalty with greater than 24 hour notification. Additional fees apply for all bookings with less than 12 hours notification. This will reflect on the Proforma Invoice. CC/EFT Payments applies to all non-account holders. Compulsory fields* Yes, I accept Type of Transfer*Airside TransferOrgan TransferDetailsAirport*OR TamboCape Town InternationalKing ShakaType*ArrivalDepartureTerminal*DomesticInternationalPLEASE NOTE: For International, you need to be at the airport clinic 3 hours before departure. For Domestic, 90 minutes before departure.Flight Number*Leaving From*Going To*Is this transfer required in less than 12 hours from time of booking?*YesNoDate* Time* : Hours Minutes Medical Information*Patient DetailsName and Surname*Nationality*Passport / ID Number*Other Details Oxygen Wheelchair Stretcher Medication IV Therapy Intubated / Ventilated Urinary Cat Medical Escort Required (to escort patient on flight) - ONLY IF YOU REQUIRE CAPE MEDICS TO PROVIDE THE ESCORTYesNoAdditional Costs apply if Doctor and/or Paramedic medical escort is required. A separate quotation will be send for the medical escort. CAPE MEDICS ESCORTPlease specify type of escort required:*ParamedicDoctorPlease provide detailsPatient Reference Number / Case Number / Authorisation NumberDo you require ground transport to or from the hospital?YesNoPlease select Type of Ground Transport RequireBLSILSALSICUReceiving Hospital*Please enter the name of the receiving hospital.Booking DetailsName and Surname of Person making Booking*Phone Number*Email* Enter Email Confirm Email PaymentPayment TypeAccountCredit Card / Instant EFTSales Code (for Account Holders)Transfer CostsOrgan Transfer Cost Price: R977.50 Airside Transfer Cost Price: R1,250.00 Airside Transfer Cost Price: R1,750.00 1 Hour Clinic Fee Price: R966.00 2 Hours Clinic Fee Price: R1,932.00 Oxygen Price: R402.50 Intubated / Ventilated Price: R1,265.00 Ground Transport (BLS) Price: R1,980.06 Ground Transport (ILS) Price: R2,616.76 Ground Transport (ALS) Price: R4,152.88 Ground Transport (ICU + ALS) Price: R8,002.88 Total Cost for Transfer R0.00 CommentsThis field is for validation purposes and should be left unchanged.