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Not fit to fly certificate template

This Medical Certificate must be completed in full, and produced at check-in and at each embarkation 2025

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The document is a Medical Certificate of Fitness to Fly, required for passengers with medical impairments that may affect their ability to fly. It must be completed fully and presented at check-in and embarkation. The certificate assesses the patient's ability to sit upright, self-manage during the flight, understand safety instructions, and whether flying poses a risk of requiring emergency medical attention. If the patient cannot meet these criteria, a Travel Carer is required. Additionally, it addresses supplemental oxygen needs during the flight and specifies permitted oxygen equipment.

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Click ‘Get Form’ to open it in the editor.
Begin by entering the 'Name of Patient' and 'Emergency Contact Name' along with their 'Contact No.' in the designated fields.
In the 'Medical Practitioner’s Declaration' section, ensure that you tick the appropriate boxes regarding the patient's ability to sit upright, self-administer medication, and understand safety instructions.
If applicable, indicate whether a Travel Carer is required by ticking 'Yes' or 'No' and providing reasons if necessary.
For oxygen requirements, complete the relevant sections by confirming if supplemental oxygen is needed during the flight and detailing any specific settings or conditions.
Finally, have the medical practitioner sign, date, and stamp the certificate before submission.

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Versions	Form popularity	Fillable & printable
2020	4.8 Satisfied (31 Votes)
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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What minimum class of medical certificate is required to operate under the full privileges of a private pilot certificate?

A third-class medical is required for: All pilots wishing to exercise privileges of a private pilot certificate. Recreational pilot certificate. Student pilot certificate.

What are the three types of medical certificates?

Menu Menu A 1st Class medical is required when flight operations require an Air Transport Pilot (ATP) certificate. A 2nd Class medical is required when flight operations require a Commercial Pilot certificate. A 3rd Class medical is required for all other flight operations that require an FAA Medical Certificate.

Who can issue 1st, 2nd, or 3rd class medical certificates?

First, Second, and Third Class Certificates The FAA issues three classes of medical certificates: A first class medical is required for pilots who exercise airline transport pilot (ATP) privileges; that is, those flying scheduled airliners and other pilots whose employers require this level of certification.

What is a valid medical certificate?

In general, the certificate should include: The name and address of the doctor and the patient. The name and address of the party requiring the certificate (if required), such as an employer or school administrator. The specific period of time off work that is medically justifiable.

What is a basic medical certificate?

BasicMed is an alternate way for pilots to fly without holding an FAA medical certificate as long as they meet certain requirements. Print off a FAA Form 8700-2; BasicMed Comprehensive Medical Examination Checklist ( CMEC ) and get your physical exam with a state-licensed physician.

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What medical certificate can I get?

Quick healthcare certifications to develop your career Home health aide certification. Emergency medical technician certification. Phlebotomy technician certification. Behavioral technician specialist certification. Medical front office administration specialist certification. Cardiac monitor technician certification.

What are the three classes of medical certificates?

Medical Certificate Duration Expiration and Renewal Schedule FAA Medical Certificate Durations PrivilegesAge 40 and Over First-Class Airline Transport Pilot 6 Months Second-Class Commercial Pilot 12 Months Third-Class Private Pilot 24 Months1 more row

How do I get a medical certificate for flying?

An FAA-designated Aviation Medical Examiner (AME) must examine you. You must contact an AME of your choosing, schedule an appointment, complete an official FAA application form via MedXPress, and undergo a physical examination by an AME.