Excerpts from Guide for Aviation Medical Examiners
Application Process for Medical Certification

Application Review
Item 64. Medical Examiner's Declaration

If the application is not transmitted electronically, the date of examination and the Examiner's name and complete address must be typed. The Examiner must personally sign the completed form. The Examiner's serial number and telephone number should be entered in the blocks provided.

The FAA designates specific individuals as Examiners, and this status may not be further delegated to a physician who may be covering the designee's practice.

Although the FAA does not require that the Examiner sign the Examiner's copy of FAA Form 8500-8, the Examiner should at least personally initial this form.

This section provides guidance for the completion of Item 64 of FAA Form 8500-8. The Examiner is responsible for conducting the examination. However, he or she may delegate to a qualified physician's assistant, nurse, aide, or laboratory assistant the testing required for Items 49-58. Regardless of who performs the tests, the Examiner is responsible for the accuracy of the findings, and this responsibility may not be delegated.

After all routine evaluations and tests are completed, the Examiner should make a complete review of FAA Form 8500-8. If the form is complete and accurate, the Examiner should add final comments, make qualification decision statements, and sign the declaration. The medical history page of FAA Form 8500-8 must be completed in the handwriting of and signed and dated by the applicant. Upon completion of the physical examination, the entire FAA Form 8500-8, Items 1 through 64, must be electronically transmitted to the FAA vis the AMCS.

Application Review Items: