Register

1. Identification & BasicMed Question

Required Registration Items

Physician's Public Display Name^*

You attest you are this physician or their authorized Agent

Email^*

Email Address will be primary login credential - not published

Password^*

Password must be at least 8 characters.

Confirm password^*

Primary Medical Degree^*

Registration is for Physicians Only

You Offer BasicMed Exams^*

Yes

Change BasicMed status anytime

I agree to the FightPhysical.com terms and conditions^*

Review Terms and Conditions and our Privacy Policy.

Optional Registration Items

Initial Message to FlightPhysical.com (Optional)

FAA HIMS Evaluations

Insurance Exams

School Exams

DOT / DMV / CDL Exams

Publicize Your External Web Site (Optional - 90 day free trial then $3 per month )

Fax Number (No Charge)

This will be published on your public web page (no charge)

Additional Degrees to Display (No Charge)

Other Degrees or Certifications you want to display on your FlightPhysical.com Listing (no charge)

Identifiers to help those Slow FlightPhysical.com Humans Verify and Approve your Registration and Public Site Modifications

Optional: Last 4 digits of FAA Published Phone No.

AME Number