**USER'S GUIDE**

***for the***

**AEROSPACE MEDICAL CERTIFICATION SUBSYSTEM**

**(AMCS)**

![](media/image1.png){width="4.811805555555556in"
height="3.145138888888889in"}

**MAY 2006**

***Prepared for: The Department of Transportation, Federal Aviation
Administration, Office of Aerospace Medicine, Washington, DC 20591***

***Prepared by: Integic, Corp.***

**TABLE OF CONTENTS**

INTRODUCTION 1

AME SYSTEM REQUIREMENTS 1

AMCS INTERNET APPLICATION 1

Pop-Up Blockers and Cookies 2

Internet Connection Issues 2

Technical Support 2

AMCS LOGIN 3

Change Password 4

PENDING EXAMS SCREEN 5

Functions 5

SEARCH APPLICANTS SCREEN 6

No Matching Records 6

Found Applicants 7

Found Exams 7

Functions 7

FORM 8500-8 DATA ENTRY SCREENS 9

Form 8500-8 Data Entry Screen Page 1 10

Functions 10

Form 8500-8 Page 1 (Items 1 thru 17.b.) 12

Form 8500-8 Page 1 (Item 18 -- Medical History) 18

Form 8500-8 Page 1 (Items 19 and 20) 20

Form 8500-8 Data Entry Screen Page 2 22

Functions 22

Form 8500-8 Page 2 (Items 21 thru 48) 24

Form 8500-8 Page 2 (Items 49 thru 58) 26

Form 8500-8 Page 2 (Items 59 thru 64) 29

Comments Screen 32

Form 8500-8 Data Entry Screen Page 3 34

Functions 34

Form 8500-8 Page 3 (Certificate Issued) 35

Form 8500-8 Page 3 (No Certificate Issued) 36

**INTRODUCTION**

The Aerospace Medical Certification Subsystem (AMCS) is an integrated
and standard system designed to vastly improve and simplify the
processing of applicant medical certification information. One of the
primary goals of the AMCS is to allow all AMEs to enter the Form 8500-8
application information directly into the system via the Internet. AMEs
will be assigned an AMCS username and password by the FAA. AMEs will
access the AMCS Internet application by connecting to the AMCS Login
Page at [https://diws1.cami.jccbi.gov](https://diws1.cami.jccbi.gov/).

This document discusses the system requirements for accessing the AMCS
Internet application and provides the instructions necessary to walk the
user through the data entry and submission process.

**AME SYSTEM REQUIREMENTS**

The AME is responsible for establishing and maintaining the Internet
access for their office. This includes signing up with an Internet
Service Provider (ISP) (e.g. AOL, CompuServe, etc.). While the FAA
cannot endorse any particular ISP, it is recommended that the AME
sign-up with one that will be able to provide Internet access at the
required speeds with as few service interruptions or connection
difficulties as possible. It is important to note that while the ISP and
operating systems utilized are up to the user, the only web browsers
that may be used are Microsoft Internet Explorer® (version 5.0 or
higher) and Netscape® (version 6.0 or higher). These web browsers
support the required 128-bit encryption that is utilized by the FAA as a
security measure. If you do not have one of these browsers installed,
you will not be granted access to the AMCS Internet web site. These
browsers are available for download from the Internet.

AMEs will also find that although their existing computer system may be
able to access the AMCS web site, performance will be greatly improved
with a computer containing a faster processor (233 MHz or higher), a
faster modem (preferably 56K), and additional RAM (64 -- 128 MB).

**AMCS INTERNET APPLICATION**

AMEs may access the AMCS Internet application by going directly to the
[AMCS Login Page](https://diws1.cami.jccbi.gov/) or by going to the FAA
website [http://www.faa.gov](http://www.faa.gov/) and selecting the
following hyperlinks.

From the FAA's home page, click on the ***Licenses & Certificates*** tab
at the top of the page. From the Licenses & Certificates page, click on
the ***Medical Certification*** link located on the left side of the
screen or listed below the Top Requests subject title. From the Medical
Certification page, click on the ***Aerospace Medical Certification
Subsystem (AMCS) Online Support*** link located below the Aviation
Medical Examiners subject title. This will take you to the [AMCS Online
Support](http://www.faa.gov/other_visit/aviation_industry/designees_delegations/designee_types/ame/amcs/)
page.

The Aerospace Medical Certification Subsystem (AMCS) Online Support page
provides important notices about policy changes and update information
concerning use of the application or enhancements made to the
application. The online support page also provides and AMCS/DIWS Login
hyperlink and hyperlinks relating to general information, support and
security.

Clicking on the [AMCS/DIWS Login](https://diws1.cami.jccbi.gov/)
hyperlink will take you to the AMCS Login Page.

**Pop-Up Blockers and Cookies**

Pop-Up Blockers must be disabled and Cookies must be enabled in order
for the AMCS Internet application to function properly.

**Internet Connection Issues**

In the event that you lose Internet connectivity prior to transmitting,
the information that was previously saved will be stored in the
database. Any data that had not been saved must be re-entered. For
example, if you entered data on page 1 of the Form 8500-8 Data Entry
screens and saved, then began entering data on page 2 when the Internet
connection was terminated, all of the information on page 1 will remain
in the database. Therefore, upon logging back into the system, you
should search for the airman again and select the pending application
for that airman, which will have a status of **'P'**. All of the saved
data will be present and you should proceed to the page of the Form
8500-8 Data Entry screens that you were on when the Internet connection
was lost and continue the data entry process.

**Technical Support**

For technical support questions please contact the AMCS Help Desk at
(405) 954-3238.

**AMCS LOGIN**

At the AMCS Login screen, type in your assigned *User Name* and
*Password* and then strike **\<Enter\>** or click the **Login** button.
If either the *User Name* or *Password* was entered incorrectly, an
error message will inform you of this. Once the correct *User Name* and
*Password* have been entered and verified, you will proceed to the AMCS
Pending Exams screen.

**NOTE**

> This web site is best viewed using a screen resolution of 1024 x 768.
> If your monitor or video display adapter cannot handle this
> resolution, you will still be able to view all of the pages. You will
> have to utilize the vertical scroll bar on the right-hand side of the
> window in order to view the information that is on the bottom of the
> screens.

![](media/image2.png){width="4.0in" height="2.4770833333333333in"}

***AMCS Login Screen***

**Change Password**

To change your password, click the **Change Password** button on the
Login screen. You will be taken to a screen where you can change your
password.

To change your password, type in your *User Name*, current *Password*,
your *New Password*, and your new password a second time to *Confirm*
it. Strike **\<Enter\>** or click the **Login** button. You will proceed
to the AMCS Pending Exams screen.

![](media/image3.png){width="3.9993055555555554in" height="2.85in"}

***Change Password Screen***

**PENDING EXAMS SCREEN**

This screen displays the exams performed by the AME's office that are in
pending status. Exams can be sorted by Applicant ID, Exam Date, SSN,
Last Name, First Name or Middle name by clicking on the appropriate
column header.

![](media/image4.png){width="6.493055555555555in"
height="3.2631944444444443in"}

***Pending Exams Screen***

**Functions:**

**SEARCH APPLICANTS TAB -** Select this tab to go to the Search
Applicants screen.

**DELETE -** Clicking on *Delete* will launch the Delete Pending screen,
where a *Delete Reason* must be selected in order to delete the related
exam information from the AMCS.

![](media/image5.png){width="5.000694444444444in"
height="1.3840277777777779in"}

**HELP** ![](media/image6.png) **--** Provides information about the
screen's functionality.

**LOGOUT** ![](media/image7.png){width="0.6298611111111111in"
height="0.19791666666666666in"} **--** Logs you out and returns you to
the Login screen.

**SEARCH APPLICANTS SCREEN**

From this screen you can choose whether to add an exam for a new
applicant or search for an existing applicant in order to add an exam to
the applicant's record or to review the applicant's previous exams.

The Search Applicants screen allows you to perform a search using an
SSN, Applicant ID, PI Number, Date of Birth or Name as the search
criteria. Performing a search will determine if the applicant currently
exists in the system and will display the applicant's exam information.

Searching by SSN, Applicant ID or PI Number should always result in a
single applicant match. Searching by DOB will bring up all applicants
with that date of birth. Searching by name will bring up all applicants
with that name.

![](media/image8.png){width="5.999305555555556in"
height="3.892361111111111in"}

***Search Applicants Screen***

**No Matching Records**

If your search does not return any records for any existing applicants,
you will be notified with a message stating so. You should verify the
search criteria were entered properly. If the information was entered
incorrectly, re-enter the search criteria. If upon reviewing the
information that was entered you determine that it was not entered
incorrectly, you should click on the **Create Applicant** button to add
an exam for a new applicant. The following message will display.

![](media/image9.png){width="5.002777777777778in"
height="0.8215277777777777in"}

If you are certain you want to create a new applicant, click **OK** and
you will proceed to the first page of the Form 8500-8 Data Entry
screens.

**Found Applicants**

If you select an existing applicant that was retrieved during your
search, when you click on the **Add Exam** link to the right of the
applicable Applicant ID number you will proceed to the first page of the
Form 8500-8 Data Entry screens with the demographic data already loaded.
It is imperative that you verify that the demographic data on the screen
matches the demographic data on the 8500-8 application. If the
information is different, you should enter the new information from the
current 8500-8 application into the appropriate fields on the screen.

**Found Exams**

**NOTE**

> MID links are only enabled if that particular exam was performed by
> the AME logged in or by someone in that AMEs' office.

To view a particular exam, click on the MID number of the exam you wish
to view. If the exam Status is **'A'**, the exam was completed and a
summary of the Form 8500-8 will be presented. If the exam Status is
**'P'**, the exam was started, but not completed and the Form 8500-8
Data Entry screens will launch with all information previously entered
and saved displayed in the appropriate fields.

**Functions:**

**PENDING EXAMS TAB -** Select this tab to go to the Pending Exams
screen.

**SSN --** Enter applicant's social security number.

**APPLICANT ID --** Enter applicant's applicant ID number.

**PI NUMBER --** Enter applicant's PI number.

**DATE OF BIRTH --** Enter applicant's date of birth in the (MM/DD/YYYY)
format.

**LAST NAME -** Enter applicant's last name.

**FIRST NAME -** Enter applicant's first name.

**MIDDLE NAME -** Enter applicant's middle name.

**SEARCH** ![](media/image10.png){width="0.6298611111111111in"
height="0.19791666666666666in"} **-** Starts the search for applicant
based on the criteria selected.

**CLEAR** ![](media/image11.png){width="0.5597222222222222in"
height="0.20069444444444445in"} **-** Clears the search fields.

**CREATE APPLICANT** ![](media/image12.png) **-** Takes you to the first
page of the Form 8500-8 Data Entry screens.

**APPLICANT ID -** Clicking on an Applicant ID number under the **Found
Applicants** section will display all of the exams for that applicant
under the **Found Exams for Highlighted Applicant** section at the
bottom of the screen.

**ADD EXAM** ![](media/image13.png){width="0.7694444444444445in"
height="0.2013888888888889in"} **--** This button is located under the
**Found Applicants** section. Clicking on this button takes you to the
first page of the Form 8500-8 Data Entry screens for the associated
applicant so that the new exam information may be entered.

**MID -** Clicking on a MID number under the **Found Exams for
Highlighted Applicant** section will display a summary of the Form
8500-8 if the status of the exam is listed as **'A'**. If the status of
the exam is listed as **'P'**, clicking on the MID number will launch
the Form 8500-8 Data Entry screens for that particular exam with the
information previously entered and saved displayed in the appropriate
fields.

**DELETE -** Clicking on *Delete* beside the exam status listed as
**'P'** will launch the Delete Pending screen, where a *Delete Reason*
must be selected in order to delete the related exam information from
the AMCS.

![](media/image5.png){width="5.000694444444444in"
height="1.3840277777777779in"}

**HELP** ![](media/image6.png) **--** Provides information about the
screen's functionality.

**LOGOUT** ![](media/image7.png){width="0.6298611111111111in"
height="0.19791666666666666in"} **--** Logs you out and returns you to
the Login screen.

**FORM 8500-8 DATA ENTRY SCREENS**

The Form 8500-8 Data Entry screens are presented on three separate
pages. Each field displays a blue **"?"**, red **"X"** or a green
**"Ok"** beside it. The **"?"** indicates that the information has not
yet been validated. The **"OK"** indicates that the information has been
validated and that information entered is acceptable. The **"X"**
indicates that a required field was left blank or that an error was
found with the information entered into a field during validation.
Holding your mouse over the **"X"** will display text describing what is
required or what the validation on that field consists of. Clicking on
the **"Ok"** or the **"X"** will take you to the text in the Guide for
Aviation Medical Examiners that explains the type of information that
belongs in that particular field.

![](media/image14.png){width="5.999305555555556in"
height="5.554861111111111in"}

***Form 8500-8 Data Entry Screens (Sample)***

### Form 8500-8 Data Entry Screen Page 1

Page 1 of the Form 8500-8 Data Entry screens was designed to resemble
the front page of the hardcopy FAA Form 8500-8.

**FUNCTIONS:**

**Data Entry -** Instructions for the individual data entry fields on
Page 1 of the data entry screens follow.

**Search Icon** ![](media/image15.png){width="0.2in"
height="0.2in"}**--** Takes you to the Search Applicants screen where
you can choose whether to add an exam for a new applicant or search for
an existing applicant in order to add an exam to the applicant's record
or to review the applicant's previous exams.

**Pending Icon** ![](media/image16.png){width="0.2in" height="0.2in"}
**--** Takes you to the Pending Exams screen, which displays exams
performed by the AME's office in a pending status.

**Page 1 Icon** ![](media/image17.png){width="0.2in" height="0.2in"}
**--** This icon, when displayed in blue, indicates that you are on page
1 of the data entry screens.

**Page 2 Icon** ![](media/image18.png){width="0.2in" height="0.2in"}
**--** Selecting this icon, when displayed in green, will save any newly
entered or updated information and take you to page 2 of the data entry
screens.

**Comments Icon** ![](media/image19.png) - Takes you to the Comments
page where you can enter comments for *Yes* radio button selections for
Item 18, Medical History, selections a. thru x; for *Abnormal* radio
button selections made for the Physical Findings, Items 25 thru 48; and
for out of range or abnormal results for items 17.a., 17.b., 19, 49, 50,
51.a., 51.b., 52 thru 57 and 59.

**Page 3 Icon** ![](media/image20.png){width="0.2in" height="0.2in"}
**--** Selecting this icon, when displayed in green, will save any newly
entered or updated information and take you to page 3 of the data entry
screens.

**Validate Icon** ![](media/image21.png){width="0.2in" height="0.2in"} -
Selecting this icon will save any newly entered or updated information,
validate that information and display a list of errors if applicable.

**Set All Blank Items in A thru X to No**
![](media/image22.png){width="2.0694444444444446in"
height="0.1986111111111111in"} **-** Sets all of the blank radio button
selections for the Medical History, Item 18, selections a. thru x. to
*No*.

**Set All No Items in A thru X to Blank**
![](media/image23.png){width="2.0625in" height="0.19791666666666666in"}
**-** Sets all of *No* radio button selections for the Medical History,
Item 18, selections a. thru x. to *Blank*. *Yes* selections will remain
selected.

**Save** ![](media/image24.png){width="0.5597222222222222in"
height="0.20069444444444445in"} **-** Selecting this button will save
any newly entered or updated information.

**Next Page** ![](media/image25.png){width="0.9590277777777778in"
height="0.2in"} **-** Selecting this button will save any newly entered
or updated information and take you to page 2 of the data entry screens.

**Help** ![](media/image6.png){width="0.6298611111111111in"
height="0.19791666666666666in"} **--** Provides information about the
screen's functionality.

**Logout** ![](media/image7.png){width="0.6298611111111111in"
height="0.19791666666666666in"} **--** Logs you out and returns you to
the Login screen.

**FORM 8500-8 PAGE 1 (ITEMS 1 THRU 17.b.)**

![](media/image26.png){width="6.0in" height="5.592361111111111in"}

**Exam Type**

Select the type of exam to be performed for the applicant from the drop
down list provided. Exam Type drop down selection eliminates the need
for Page 0. Validation is based on the type of exam selected. **NOTE:**
Drop down selections are available only to AMEs designated to perform
FAA Employee exams.

## AME Serial Number

Allows AMEs designated to perform FAA Employee exams to enter or update
the AME Serial Number. This was formerly done on Page 0.

**1. Application For**

Select either the *Airman Medical Cert* or *Airman Medical & Student
Pilot Cert* radio button to indicate the type of certificate being
applied for.

**2. Class of Medical Certificate**

Select either the *1^st^*, *2^nd^* or *3^rd^* radio button to indicate
the class of certificate being applied for.

**3. Last Name**

Enter the applicant's last name.

**First Name**

Enter the applicant's first name.

**Middle Name**

Enter the applicant's middle name.

**Suffix**

Enter the applicant's name suffix if applicable. Name suffixes JR, SR
and roman numerals I through XVII only will be accepted. All punctuation
should be omitted.

**4. SSN**

Enter that applicant's Social Security Number, or pseudo SSN if they
would prefer not to provide their SSN.

**NOTE**

> If the applicant does not have a pseudo SSN and does not wish to
> provide their SSN, click on the check box next to
> *International/Declined to Submit*. When this option is selected, a
> pseudo SSN will be assigned to the applicant. The applicant should be
> given the SSN to use on future 8500-8 applications.

**5. Address**

Enter the applicant's street address. When entering the applicant's
street address DO NOT use any punctuation (e.g., Rolling Ave. should be
entered Rolling Ave).

**Telephone Number**

Enter the applicant's telephone number.

## City

Enter the applicant's city. When entering the name of the city the
applicant lives in be sure that no numbers or punctuation are used if
the applicant lives in the United States (e.g., St. Louis should be
entered St Louis). If the applicant lives in a foreign country the city
name may contain numbers, but no punctuation.

**State**

Select the applicant's state from the drop down list provided, or leave
blank if international.

## Country

This field defaults to USA. Select the applicant's country of residence
from the drop down list provided, or select Other (Unknown). When
selecting the applicant's State and Country, either a state or foreign
country must be selected, but not both.

**Zip Code**

Enter the applicant's zip code.

**6. Date of Birth**

Enter the applicant's date of birth in the (MM/DD/YYYY) format. If
applying for an Airman Medical & Student Pilot Certificate, the
applicant's birthday must be at least 16 years prior to today's date.
The date entered must also be a valid date, no later than today's date,
and no earlier than the 19^th^ century.

**7. Hair Color**

Select the applicant's hair color from the drop down list provided.

**8. Eye Color**

Select the applicant's eye color from the drop down list provided.

**9. Sex**

Select either the *Male* or *Female* radio button.

**Citizenship**

This field defaults to USA. Select the country the applicant is
currently a citizen of.

**Certificate/Form Number**

Enter the number indicated on the medical certificate excluding the
alpha characters (i.e., FF, GG, etc.) preceding the number.

**10. Type of Airman Certificate(s) You Hold**

Check all that apply. If None is checked, no other boxes should be
checked. If Other is checked you must enter something into the text box
to the right of the Other option.

**11. Occupation**

Enter the applicant's occupation.

**12. Employer**

Enter the name of the applicant's employer.

**13. Has Your FAA Airman Medical Certificate Ever Been Denied,
Suspended or Revoked**

Select either the *Yes* or *No* radio button. If yes is selected, you
must enter the date of the denial, suspension or revocation in the
(MM/DD/YYYY) format. The date entered must be a valid date, no later
than today's date, and no earlier than the 19^th^ century.

**14. Total Pilot Time (Civilian Only) To Date**

Enter the number of pilot hours (in whole numbers) to date.

**15. Total Pilot Time (Civilian Only) Past 6 Months**

Enter the number of pilot hours (in whole numbers) during the past 6
months. The number of hours listed in 15 should not exceed the number of
hours listed in 14.

**16. Date of Last FAA Medical Application**

If the applicant had previous exams, this field should populate with the
date of the latest exam. If this is the applicant's first application,
check the **No Prior Application** check box.

**NOTE**

> If 13 is "No" and 16 is blank, the **No Prior Application** box must
> be checked.

**17.a. Do You Currently Use Any Medication (Prescription or
Nonprescription)**

Select either the *Yes* or *No* radio button. If Yes is selected,
continue entering the necessary medication information.

1.  Enter the name of the medication prescribed.

![](media/image27.png){width="5.0in" height="1.80625in"}

2.  If an exact match for the medication cannot be found in the database
    an error message will display and a drop down list of possible
    matches will be provided.

> If the drug name entered is a valid drug name that should be added to
> the database, check the *Add Medication to Database* checkbox and
> click the ![](media/image28.png){width="0.4201388888888889in"
> height="0.15069444444444444in"} button. Click the
> ![](media/image29.png){width="0.4201388888888889in"
> height="0.15069444444444444in"} button to refresh the screen.
>
> ![](media/image30.png){width="4.999305555555556in"
> height="2.7069444444444444in"}

3.  Select the correct medication name.

4.  If the applicant misspelled the medication on the form, the spelling
    the applicant used should be entered into the *Applicant Spelling if
    Incorrect* box.

5.  Type in the Dosage Amount and select the Dosage Unit and Frequency
    from the drop down lists provided.

6.  If the medication has been previously reported, check the check box
    below the Previously Reported column.

7.  Click the ![](media/image28.png){width="0.4201388888888889in"
    height="0.15069444444444444in"} button. The medication and its
    associated dosage information will display below the appropriate
    column headings.

![](media/image31.png){width="5.000694444444444in"
height="1.801388888888889in"}

8.  Repeat this procedure for each medication listed.

9.  The medication and its information will populate in the comments box
    for block 60 so that AME can comment on the medication(s).

10. Click on the *Edit* link to update the associated medication.

11. Click on the *Delete* link to delete the associated medication from
    the exam.

**17.b. Do You Ever Use Near Vision Contact Lens(es) While Flying**

Select either the *Yes* or *No* radio button

**FORM 8500-8 PAGE 1 (ITEM 18 -- MEDICAL HISTORY)**

![](media/image32.png){width="5.997916666666667in"
height="3.4243055555555557in"}

**18. Medical History -- Have You Ever In Your Life Been Diagnosed With,
Had, Or Do You Presently Have Any Of The Following**

Select either the *Yes* or *No* radio button for each of the items a.
thru x. All items marked "yes" require a comment.

If all of the items on the 8500-8 application are checked as "No" you
can click on the ![](media/image22.png){width="1.5506944444444444in"
height="0.14791666666666667in"} button. Each item's *No* radio button
will be selected.

Clicking on the ![](media/image33.png){width="1.55in"
height="0.14791666666666667in"} button will clear the "No" selections.

#### Conviction and/or Administrative Action History

Select either the *Yes* or *No* radio button for items v. and w. The
airman should be contacted if this field was left blank.

If any of the items a. thru x. were checked as "Yes" on the 8500-8
application, you must select the *Yes* radio button.

**Applicant Explanations**

Applicant explanations that must be entered for medical history items
where the *Yes* radio button was selected shall be entered into the
bottom section of the Comments screen

Click on the ![](media/image19.png){width="0.2in" height="0.2in"} icon
on the left side of the page and enter the applicant's comments in the
Applicant Explanation area of the screen that will launch.

![](media/image34.png){width="5.998611111111111in"
height="4.266666666666667in"}

**FORM 8500-8 PAGE 1 (ITEMS 19 AND 20)**

![](media/image35.png){width="5.998611111111111in"
height="4.680555555555555in"}

**19. Have You Visited any Health Professionals Within last 3 Years**

Select either the *Yes* or *No* radio button. If Yes is selected, enter
at a minimum, the date of the visit in the (MM/YYYY) format, the country
and the reason for seeing a physician into the boxes provided. The date
entered must be a valid date, no later than today's date, and no earlier
than the 19^th^ century. Information should be entered into the
remaining boxes if the applicant provided the information.

Click on the ![](media/image28.png){width="0.4201388888888889in"
height="0.14791666666666667in"} button and the information you entered
will appear under the appropriate headings underneath the
![](media/image28.png){width="0.4201388888888889in"
height="0.14791666666666667in"} button and the fields will clear. The
Edit and Delete options that correspond with each visit allow you to
update the visit information or completely delete the visit from the
record.

Clicking on the Edit link will display that visit's information in the
boxes provided and ![](media/image36.png){width="0.4597222222222222in"
height="0.15138888888888888in"} and
![](media/image29.png){width="0.4201388888888889in"
height="0.15069444444444444in"} buttons will replace the
![](media/image28.png){width="0.4201388888888889in"
height="0.14791666666666667in"} button. Update as necessary and click
the ![](media/image36.png){width="0.4597222222222222in"
height="0.15138888888888888in"} button. The fields will clear, the
![](media/image28.png){width="0.4201388888888889in"
height="0.14791666666666667in"} button returns and the information will
again appear under the appropriate headings. You may cancel the editing
process by clicking the
![](media/image29.png){width="0.4201388888888889in"
height="0.15069444444444444in"} button

**20. Applicant's National Driver Register and Certifying Declarations**

Select either the *Yes* or *No* radio button. If the applicant signed
the form, select Yes and enter the date on which the form was signed in
the (MM/DD/YYYY) format. The date entered must be a valid date, no later
than today's date, and no earlier than the 19^th^ century. You must
enter the date if Yes is selected.

> To proceed to Page 2 of the Form 8500-8 Data Entry screens click on
> the ![](media/image25.png){width="0.7194444444444444in"
> height="0.14791666666666667in"} button at the bottom right of the
> screen.
>
> -OR-
>
> Click on the ![](media/image18.png){width="0.2in" height="0.2in"} icon
> at the top left of the screen. Information entered on Page 1 will be
> saved and you will be taken to Page 2 of the Form 8500-8 Data Entry
> screens.

**Form 8500-8 Data Entry Screen Page 2**

Page 2 of the Form 8500-8 Data Entry screens was designed to resemble
the back page of the hardcopy FAA Form 8500-8.

**FUNCTIONS:**

**Data Entry -** Instructions for the individual data entry fields on
Page 2 of the data entry screens follow.

**Search Icon** ![](media/image15.png){width="0.2in" height="0.2in"}
**--** Takes you to the Search Applicants screen where you can choose
whether to add an exam for a new applicant or search for an existing
applicant in order to add an exam to the applicant's record or to review
the applicant's previous exams.

**Pending Icon** ![](media/image16.png){width="0.2in" height="0.2in"}
**--** Takes you to the Pending Exams screen, which displays exams
performed by the AME's office in a pending status.

**Page 1 Icon** ![](media/image37.png){width="0.2in" height="0.2in"}
**--** Selecting this icon, when displayed in green, will save any newly
entered or updated information and take you to page 1 of the data entry
screens.

**Page 2 Icon** ![](media/image38.png){width="0.2in" height="0.2in"}
**--** This icon, when displayed in blue, indicates that you are on page
2 of the data entry screens.

**Comments Icon** ![](media/image19.png) - Takes you to the Comments
page where you can enter comments for *Yes* radio button selections for
Item 18, Medical History, selections a. thru x; for *Abnormal* radio
button selections made for the Physical Findings, Items 25 thru 48; and
for out of range or abnormal results for items 17.a., 17.b., 19, 49, 50,
51.a., 51.b., 52 thru 57 and 59.

**Page 3 Icon** ![](media/image20.png){width="0.2in" height="0.2in"}
**--** Selecting this icon, when displayed in green, will save any newly
entered or updated information and take you to page 3 of the data entry
screens.

**Validate Icon** ![](media/image21.png){width="0.2in" height="0.2in"} -
Selecting this icon will save any newly entered or updated information,
validate that information and display a list of errors if applicable.

**Set All Blank Items in 25 thru 48 to Normal**
![](media/image39.png){width="2.3993055555555554in" height="0.2in"}
**-** Sets all of the blank radio button selections for Physical
Findings, Items 25 thru 48 to *Normal*.

**Set All Normal Items in 25 thru 48 to Blank**
![](media/image40.png){width="2.3993055555555554in" height="0.2in"}
**-** Sets all *Normal* radio button selections for Physical Findings,
Items 25 thru 48 to *Blank*. *Abnormal* selections will remain selected.

**Save** ![](media/image24.png){width="0.5597222222222222in"
height="0.20069444444444445in"} **-** Selecting this button will save
any newly entered or updated information.

**Previous Page** ![](media/image41.png){width="1.2in" height="0.2in"}
**-** Selecting this button will save any newly entered or updated
information and take you back to page 1 of the data entry screens.

**Next Page** ![](media/image25.png){width="0.9590277777777778in"
height="0.2in"} **-** Selecting this button will save any newly entered
or updated information and take you to page 3 of the data entry screens.

**Help** ![](media/image6.png){width="0.6298611111111111in"
height="0.19791666666666666in"} **--** Provides information about the
screen's functionality.

**Logout** ![](media/image7.png){width="0.6298611111111111in"
height="0.19791666666666666in"} **--** Logs you out and returns you to
the Login screen.

**FORM 8500-8 PAGE 2 (ITEMS 21 THRU 48)**

![](media/image42.png){width="5.998611111111111in"
height="4.778472222222222in"}

**21. Height (in.)**

Enter the applicant's height in inches. A valid height between 36 and 90
inches only will be accepted.

**22. Weight (lbs.)**

Enter the applicant's weight in pounds. A valid weight between 50 and
450 pounds only will be accepted.

**23. Statement of Demonstrated Ability (SODA)**

Select either the Yes or No radio button. If Yes is selected, you must
enter the SODA number.

**24. SODA \#**

Enter the SODA Serial number.

**Defect Noted**

Enter defects noted.

**25 thru 48. Physical Findings**

Select either the *Normal* or *Abnormal* radio button for each of the
items 25 thru 48. All items marked "abnormal" require a comment.

If all of the items are Normal you can click on the
![](media/image39.png){width="1.7993055555555555in"
height="0.14791666666666667in"} button. Each item's *Normal* radio
button will be selected. Items 39 and 41 should remain blank if the
applicant is female.

Clicking on the ![](media/image40.png){width="1.7993055555555555in"
height="0.14791666666666667in"} button will clear the "Normal"
selections.

**Comments on Physical Findings**

Comments that must be entered for physical findings, items 25 thru 48,
where the *Abnormal* radio button was selected shall be entered into the
top section of the Comments screen

Click on the ![](media/image19.png){width="0.2in" height="0.2in"} icon
on the left side of the page and enter comments in the AME comment area
of the screen that will launch. If item is disqualifying the AME should
check the box beside the item number.

![](media/image43.png){width="5.998611111111111in"
height="2.777083333333333in"}

**FORM 8500-8 PAGE 2 (ITEMS 49 THRU 58)**

![](media/image44.png){width="5.997222222222222in"
height="2.886111111111111in"}

**49. HEARING**

**NOTE**

> Applicant must pass at least one test (Conversational, Speech
> Discrimination or Audiometer). AME comments are required in block 60
> for failure to pass.

**Conversational Voice at 6 Feet**

Select either the *Pass* or *Fail* radio button. The applicant must
demonstrate hearing of an average conversational voice in a quiet room,
using both ears, at 6 feet, with the back turned to the Examiner in
order to pass.

**Speech Discrimination**

Enter the speech discrimination result in the box provided. The
applicant must score at least 70 percent at intensity no greater than 65
dB in either ear in order to pass.

**Audiometer (Threshold in Decibels)**

Enter the Audiometer results in the appropriate boxes. The applicant's
results should be better than or meet the following audiometric
standards in order to pass.

  ------------------------------ ---------- ---------- --------- ----------
  **Frequency (Hz)**             **500 Hz** **1000     **2000    **3000
                                            Hz**       Hz**      Hz**

  Better ear (dB)                35         30         30        40

  Poorer ear (dB)                35         50         50        60
  ------------------------------ ---------- ---------- --------- ----------

**50. Distant Vision**

Enter the distance vision results in the appropriate boxes. Distant
vision standards can vary depending on exam type and class of
certificate being applied for. Reference the AME Guide for the
appropriate standards if necessary. AME comments are required in block
60 for out of range distant vision results.

**51a. Near Vision**

Enter the near vision (at 16 inches) results in the appropriate boxes.
Near vision standards can vary depending on exam type and class of
certificate being applied for. Reference the AME Guide for the
appropriate standards if necessary. AME comments are required in block
60 for out of range near vision results.

**51b. Intermediate Vision**

Enter the intermediate vision (at 32 inches) results in the appropriate
boxes. Intermediate vision standards can vary depending on exam type and
class of certificate being applied for. Reference the AME Guide for the
appropriate standards if necessary. AME comments are required in block
60 for out of range intermediate vision results.

**52. Color Vision**

Select either the *Pass* or *Fail* radio button. Errors that would keep
an applicant from meeting the color vision standards are listed in the
AME Guide. AME comments are required in block 60 if applicant fails
color vision test.

**53. Field of Vision**

Select either the *Normal* or *Abnormal* radio button. The AME Guide
describes different methods of determining whether or not the
applicant's field of vision is within a normal range. AME comments are
required in block 60 if field of vision results are abnormal.

**54. Heterophoria 20' (In Prism Diopters)**

Enter the Heterophoria test results in the boxes provided. Heterophoria
standards can vary depending on exam type and class of certificate being
applied for. Reference the AME Guide for the appropriate standards if
necessary. AME comments are required in block 60 for test results that
exceed the specified standards.

**55. Blood Pressure**

Enter the Systolic and Diastolic blood pressure readings in the boxes
provided. The average blood pressure while sitting should not exceed 155
mm mercury systolic and 95 mm mercury diastolic maximum pressure for all
classes. AME comments are required in block 60 if blood pressure
readings are above specified limits.

**56. Pulse**

Enter the pulse reading in the box provided. There is no specified pulse
rate that is considered disqualifying. However, abnormal pulse rates may
be reason to conduct additional cardiovascular system evaluation and
deferral may be indicated. AME comments are required in block 60 for
abnormal pulse rates.

**57. Urinalysis (If Abnormal, Give Results)**

Select either the *Normal* or *Abnormal* radio button. If Abnormal is
selected, you must enter the Albumin and Sugar results in the boxes
provided. You may also enter Albumin and Sugar results for normal
urinalysis if desired. Reference the AME Guide for the most common
conditions of aeromedical significance, and course of action that should
be taken by the Examiner. AME comments are required in block 60 if
results are abnormal.

**58. ECG Date**

Enter the date of the applicant's most recent ECG, if applicable in the
(MM/DD/YYYY) format. Reference the AME Guide for the regulations
regarding which applicant's require ECGs and how often. The date entered
must be a valid date, no later than today's date, and no earlier than
the 19^th^ century.

**FORM 8500-8 PAGE 2 (ITEMS 59 THRU 64)**

![](media/image45.png){width="5.998611111111111in"
height="3.1902777777777778in"}

**59. Other Tests Given**

Enter any additional medical information in the box provided. Additional
medical information may be furnished through additional history taking,
further clinical examination procedures and supplemental laboratory
procedures. AME comments are required in Block 60 when additional
information is obtained.

**60. Comments on History and Findings**

Comments that must be entered for the Yes answers in the applicant's
medical history and for out of range or abnormal results for items
17.a., 17.b., 19, 49, 50, 51.a., 51.b., 52 thru 57 and 59. shall be
entered in the bottom section of the Comments screen

Click on the ![](media/image19.png){width="0.2in" height="0.2in"} icon
on the left side of the page and enter comments in the AME comment area
of the screen that will launch. If item is disqualifying the AME should
check the box beside the item number.

![](media/image46.png){width="5.998611111111111in" height="4.8375in"}

**Significant Medical History**

Select the *Yes* or *No* radio button.

**Abnormal Physical Findings**

Select the *Yes* or *No* radio button.

**62. Has Been Issued (Certificate Status)**

Select the appropriate radio button to indicate what type of certificate
was issued or to indicate whether or not the certificate was deferred or
denied. The applicant must meet the minimum age requirement (16 years)
in order for a Medical and Student Pilot Certificate to be issued.

**63. Disqualifying Defects**

Items that an AME checks as disqualifying in the applicable areas of the
Comments screen will be listed in this box by item number (e.g., 18v,
44, 53).

**64. Medical Examiner's Declaration --** I hereby certify that I have
personally reviewed the medical history and personally examined the
applicant named on this medical examination report. This report with any
attachment embodies my findings completely and correctly.

**Medical Exam Date**

Enter the date of the examination in the (MM/DD/YYYY) format. The date
entered must be a valid date, no later than today's date, and no earlier
than the 19^th^ century.

**AME Declaration**

Select the *Yes* or *No* radio button. Yes indicates that the AME has
read the declaration and has signed the 8500-8 application.

> Clicking on the ![](media/image25.png){width="0.7194444444444444in"
> height="0.14791666666666667in"} button at the bottom right of the
> screen will take you to the Comments screen. Enter any necessary
> comments and click on the
> ![](media/image25.png){width="0.7194444444444444in"
> height="0.14791666666666667in"} button at the bottom right of the
> Comments screen to proceed to Page 3 of the Form 85008- Data Entry
> screens.
>
> -OR-
>
> Click on the ![](media/image20.png){width="0.2in" height="0.2in"} icon
> at the top left of the screen. Information entered on Page 2 will be
> saved and you will be taken to Page 3 of the Form 8500-8 Data Entry
> screens.

**Comments Screen**

The Comments screen was designed to provide a central location in which
to enter explanations and comments pertaining to an applicant's medical
history, comments related to any abnormal physical findings and comments
for other out of range or abnormal results.

![](media/image47.png){width="5.999305555555556in"
height="7.699305555555555in"}

**Comments on Physical Findings**

AME comments that must be entered for physical findings, items 25 thru
48, where the *Abnormal* radio button was selected shall be entered into
the top section of the Comments screen.

**Applicant Explanations**

Applicant explanations that must be entered for medical history items
where the *Yes* radio button was selected shall be entered into the
bottom section of the Comments screen where applicable.

**Comments on History and Findings**

AME comments that must be entered for the Yes answers in the applicant's
medical history and for out of range or abnormal results for items
17.a., 17.b., 19, 49, 50, 51.a., 51.b., 52 thru 57 and 59, shall be
entered in the bottom section of the Comments screen

**Form 8500-8 Data Entry Screen Page 3**

Page 3 of the Form 8500-8 Data Entry screens was designed to present
itself as Certificate Issued or No Certificate Issued as applicable and
is where the AME will submit the exam to the DIWS database.

**FUNCTIONS:**

**Search Icon** ![](media/image15.png){width="0.2in" height="0.2in"}
**--** Takes you to the Search Applicants screen where you can choose
whether to add an exam for a new applicant or search for an existing
applicant in order to add an exam to the applicant's record or to review
the applicant's previous exams.

**Pending Icon** ![](media/image16.png){width="0.2in" height="0.2in"}
**--** Takes you to the Pending Exams screen, which displays exams
performed by the AME's office in a pending status.

**Page 1 Icon** ![](media/image37.png){width="0.2in" height="0.2in"}
**--** Selecting this icon, when displayed in green, will save any newly
entered or updated information and take you to page 1 of the data entry
screens.

**Page 2 Icon** ![](media/image18.png){width="0.2in" height="0.2in"}
**--** Selecting this icon, when displayed in green, will save any newly
entered or updated information and take you to page 2 of the data entry
screens.

**Comments Icon** ![](media/image19.png) - Takes you to the Comments
page where you can enter comments for *Yes* radio button selections for
Item 18, Medical History, selections a. thru x; for *Abnormal* radio
button selections made for the Physical Findings, Items 25 thru 48; and
for out of range or abnormal results for items 17.a., 17.b., 19, 49, 50,
51.a., 51.b., 52 thru 57 and 59.

**Page 3 Icon** ![](media/image48.png){width="0.2in" height="0.2in"}
**--** This icon, when displayed in blue, indicates that you are on page
3 of the data entry screens.

**Validate Icon** ![](media/image21.png){width="0.2in" height="0.2in"} -
Selecting this icon will save any newly entered or updated information,
validate that information and display a list of errors if applicable.

**Save** ![](media/image24.png){width="0.5597222222222222in"
height="0.20069444444444445in"} **-** Selecting this button will save
any newly entered or updated information.

**Previous Page** ![](media/image41.png){width="1.2in" height="0.2in"}
**-** Selecting this button will save any newly entered or updated
information and take you back to page 2 of the data entry screens.

**Submit Exam** ![](media/image49.png){width="1.0in" height="0.2in"}
**-** Selecting this button will perform a final validation of the exam
information, which will launch either a window depicting the fields that
contain an error or a window displaying a message that the exam
submitted successfully.

**Help** ![](media/image6.png){width="0.6298611111111111in"
height="0.19791666666666666in"} **--** Provides information about the
screen's functionality.

**Logout** ![](media/image7.png){width="0.6298611111111111in"
height="0.19791666666666666in"} **--** Logs you out and returns you to
the Login screen.

**FORM 8500-8 PAGE 3 (CERTIFICATE ISSUED)**

![](media/image50.png){width="6.0in" height="5.0in"}

If *Medical Certificate* or *Medical and Student Pilot Certificate*
under Certificate Status was selected on Page 2 of the Form 8500-8 Data
Entry screens, the Medical Certificate screen will launch.

**Medical Certificate Class**

Select the appropriate classification granted from the drop down list
provided.

**Limitations**

Select the limitation(s) that apply.

**FORM 8500-8 PAGE 3 (NO CERTIFICATE ISSUED)**

![](media/image51.png){width="6.0in" height="2.7381944444444444in"}

If *No Certificate Issued --Deferred for Further Evaluation, Has Been
Denied -- Letter of Denial Issued (Copy Attached)* or *FAA ATC--Deferred
-- No Certificate Issued* under Certificate Status was selected on Page
2 of the Form 8500-8 Data Entry screens, a screen indicating that no
certificate will be issued by the AME will launch.

**Submitting Exams**

Once all of the necessary data has been entered, click on the **Submit
Exam** button on the bottom of Page 3 of the Form 8500-8 Data Entry
screens. If all of the data passes the final validation stage, a window
will appear displaying a message indicating that the exam was submitted
successfully along with the Applicant ID number, MID number, applicant's
DOB as well as the applicant's name and address.

![](media/image52.png){width="5.498611111111111in" height="1.35625in"}

The MID number uniquely identifies this examination within the DIWS
database. The Applicant ID uniquely identifies the individual within the
DIWS database. These numbers should be included on all correspondence
associated with this application as it will allow the FAA to quickly
locate an airman's record.

Clicking the ![](media/image53.png){width="1.179861111111111in"
height="0.1986111111111111in"} button presents a summary of the
completed Form 8500-8.

If the data does NOT pass the final validation stage, error messages
will display at the top of the page. Clicking on the error will take you
to the appropriate page of the Form 8500-8 Data Entry screens so you can
correct the error.

![](media/image54.png){width="5.997916666666667in"
height="3.2118055555555554in"}