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ORDER FORM
Medical Forms & Stationery Requisition

  • Please indicate the required quantity in the box to the left of each form you are ordering. Your Name, 5-digit AME number, and email address are required fields as your order cannot be transmitted without these.
  • If your office phone number or address has changed since your last order, please complete the optional fields. You must also contact your Regional Flight Surgeon’s office to have your address updated.
  • Allow up to 21 days (mostly for international requests) for orders to be processed and delivered via the USPS. Is your need for additional forms urgent? We can ship one package of the 8500-8 forms Priority Mail (USPS), 3 to 5 business days or at the requester’s expense using FedEx. Phone 405-954-4831 if your need of forms is urgent. If FedEx is desired, please have ready your FedEx account number.
  • Limit requests to approximate annual usage.

(*)Denotes required field(s)

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Quantity
FAA / AC
Form Number
Title


 

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THE FOLLOWING FORMS ARE NO LONGER AVAILABLE BY MAIL.
YOU MAY PRINT COPIES BY SELECTING THE "PRINT" BUTTON.

Print
FAA / AC
Form Number
Title
Print Form 'FAA 8065-1'
FAA 8065-1
Electrocardiogram Transmittal
Print Form 'FAA 8500-2'
FAA 8500-2
Letter of Denial
Print Form 'FAA 8500-14'
FAA 8500-7
Report of Eye Evaluation
Print Form 'FAA 8500-14'
FAA 8500-14
Ophthalmological Evaluation of Glaucoma
Print Form 'FAA 8500-19'
FAA 8500-19
Cardiovascular Evaluation Specifications
Print Form 'FAA 8500-21'
FAA 8500-21
Authorization For The Release Of Medical Information To The Federal Aviation Administration (FAA)
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