Get the free AG-521 Medical Certification form for Employee - Administrative ... - agrilifeas tamu

AG-521 (10/01/13) Texas A&M Airline Administrative Services Human Resources Medical Certification Form for EMPLOYEE The employee must have this form completed by a licensed health care provider and

How to fill out ag-521 medical certification form

Who needs ag-521 medical certification form?

1. Pilots and air traffic controllers who hold, or are applying for, a Federal Aviation Administration (FAA) medical certificate need the ag-521 medical certification form.
2. This form is required for individuals to demonstrate their physical fitness for performing the duties and responsibilities associated with their aviation-related positions.

How to fill out ag-521 medical certification form:

1. Start by obtaining the form: The ag-521 form can be obtained from the FAA's official website, or you may request it from the FAA directly.
2. Read the instructions: Before filling out the form, carefully read the instructions provided. They will guide you through the process and help ensure that you complete the form correctly.
3. Personal information: Begin by providing your personal information, including your name, date of birth, and social security number. Fill in the required fields accurately and clearly.
4. Medical history: Next, provide information about your medical history. This includes details about any medical conditions, surgeries, medications, or treatments you have had or are currently undergoing. Be thorough and provide all necessary information.
5. Medications: If you take any medications, list them in this section. Include the name of the medication, dosage, and reasons for taking them. It is important to disclose all medications to the FAA, as they may have an impact on your medical certification.
6. Doctor's information: Fill in the section regarding your treating physician or medical examiner. Provide their contact information, including name, address, and phone number. This is crucial as the FAA may need to reach out to them for verification or additional information.
7. Certification: Review the form and ensure that all the information provided is accurate and complete. Sign and date the form to certify the accuracy of the information you have provided.
8. Submitting the form: Once you have filled out and signed the ag-521 form, submit it to the FAA via mail or electronically, as specified in the instructions.

Remember, accuracy and honesty are paramount when completing the ag-521 medical certification form. It is crucial to provide a comprehensive overview of your medical history to ensure an appropriate evaluation of your medical fitness.

For pdfFiller’s FAQs

What is ag-521 medical certification form?

The AG-521 medical certification form is a document that verifies an individual's medical condition.

Who is required to file ag-521 medical certification form?

Individuals who are seeking medical certification for a specific condition are required to file the AG-521 form.

How to fill out ag-521 medical certification form?

The AG-521 form should be completed with accurate and up-to-date information regarding the individual's medical condition.

What is the purpose of ag-521 medical certification form?

The purpose of the AG-521 medical certification form is to provide evidence of an individual's medical condition for certification or approval purposes.

What information must be reported on ag-521 medical certification form?

The AG-521 form must include detailed information about the individual's medical condition, treatment plan, and healthcare provider.

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