Air UK admitted that the questionnaire sent to William Chambers, which also referred to him as a patient rather than as a passenger, was "antiquated" and it would amend it.
But Tony Le Masurier, customer services director of the airline, insisted that content of the question remained relevant and only the way it was worded should change. "There are characteristics which do impinge on others. Let's be honest about this," he said.
The form, sent to Mr Chambers, from Motherwell, Scotland, asked: "Is the patient in any way offensive to other passengers (smell, appearance, conduct)?"
Designed to be filled in by Mr Chamber's doctor, it also referred to Mr Chambers as a "patient" rather than a customer or passenger and asked about arrangements for "delivery" and "collection" at either end of his flight.
Mr Chambers, 55, said yesterday: " I absolutely could not believe it. I am quite used to flying and I have never seen a form like this before. What on earth was I supposed to think when I read it?"
Mr Chambers, who worked as a financial adviser until his illness forced him to retire, added that he had no choice but to ask his GP to fill in the form in order to take the flight on April 13 from Glasgow to Gatwick to connect with a Delta Airlines flight to Florida.
Sheila Williams, spokeswoman for the disabled charity Capability Scotland, said:"It's unbelievable that a company the size of Air UK can hold these views and treat disabled customers in such a manner."
The form was based on a standard document drawn up by the International Air Transport Association and intended to ease the transfer of disabled passengers between different carriers.Reuse content