Steps for Requesting Premium (First Or Business) Class Travel Due to a Medical Condition

The actual “Request For Premium Class Common Carrier Travel Accommodations For Employees With Medical Conditions” form is available HERE: http://share.csr.nih.gov/SREA/Documents/GuidelinesCompletingRequestPremiumClassTravel.pdf Look in right hand column under travel – then travel forms. It is the first document – Premium/Business Class Travel Request.

Instructions:

Steps for Requesting Premium (First or Business) Class Travel Due to a Medical Condition:

It is recommended that requests for authorization for the use of premium class travel be made 4-6 weeks in advance of the travel date.

The reviewer must complete the following 2 steps to receive authorization:

1. Complete the “Request For Premium Class Common Carrier Travel Accommodations For Employees With Medical Conditions” form (see attachment) and submit to the SREA Office via email to . The SREA Office will obtain Executive Officer approval signature and forward the form to Occupational Medical Services (OMS) on the reviewer’s behalf.

2. Submit copies of existing relevant medical records and a letter from your physician supporting the request, directly to OMS via fax or email to:

Occupational Medical Services (OMS)

Attention: Carolyn A. Fleeger

Fax: 301-402-0673

Email:

NOTE: Do not submit medical records or physician’s letter to the SREA Office or World Travel Service

3. Complete the “Request For Premium Class Common Carrier Travel Accommodations For Employees With Medical Conditions” form (see attachment) and submit to the IC SREA Officer, David Alperin, at . The SREA Officer will obtain Executive Officer approval signature and forward the form to Occupational Medical Services (OMS) on the reviewer’s behalf.

Because the SREA website is for CSR they, of course, have the form sent to their SREA office. However, the form needs to be signed by your IC’s Executive Officer. CMO will take care of getting the signature and sending the form to OMS to combine with the medical forms – and they will send the package to Deputy Director for Management for final signature.