How to Fill Out the FAA CACI Form for Pilot Medical Certification

The FAA’s Conditions AMEs Can Issue (CACI) program lets an Aviation Medical Examiner issue your medical certificate the same day for certain stable conditions, but only if you walk in with the right paperwork. There is no single “CACI form.” Instead, each eligible condition has its own worksheet listing exactly what the AME must see, and your job is to arrive with documents that match every item on that worksheet. Submit FAA Form 8500-8 through MedXPress ahead of the visit, bring a recent treating-physician progress note plus the required labs and medication list, and if everything meets the worksheet criteria the AME issues the certificate on the spot.¹

Confirm Your Condition Is on the CACI List

The FAA maintains a fixed list of conditions eligible for the CACI pathway. As of March 2026, it covers 28 conditions, including hypertension, asthma, glaucoma, hypothyroidism, prediabetes, migraine and chronic headache, arthritis, several cancers (bladder, breast, colon/colorectal, prostate, renal, testicular), chronic kidney disease, hepatitis C, mitral valve repair, essential tremor, PCOS, psoriasis, and weight loss management.¹

Being on the list is only the first hurdle. The condition also has to be stable and well-controlled. If it’s actively progressing, causing functional impairment, or falling outside the worksheet’s clinical parameters, the AME cannot issue and will defer the application to the FAA instead.

Download the Worksheet Before Your Appointment

The worksheets are public. Pull the one for your specific condition from the FAA’s CACI page and read it end to end before you schedule anything.¹ Every worksheet follows the same skeleton: a current clinical progress note, recent lab work or diagnostic testing, and a complete medication list. The specifics differ by condition.

The Clinical Progress Note

This is the document that makes or breaks the visit. The AME needs a detailed note from a clinic visit with your treating physician or specialist conducted no more than 90 days before the AME exam.² A brief “patient is doing well” note isn’t enough. The progress note should address the worksheet’s stability criteria directly: treatment history, current medications with dosages, side effects, and the physician’s assessment that the condition is controlled.

If your doctor’s notes tend to run short, bring the worksheet to your appointment and ask the physician to address each point on it. That single step prevents most avoidable deferrals.

Condition-Specific Clinical Thresholds

Beyond the progress note, each worksheet sets its own benchmarks. A few of the common ones:

Hypertension: blood pressure measured at the AME’s office must be at or below 155 systolic and 95 diastolic. The worksheet notes that 155/95 is acceptable for certification but flags that pilots above normal clinical thresholds should follow up with their primary provider for further management.²
Asthma: symptoms stable and well-controlled, with flare-ups no more than two days per week and rescue inhaler use no more than twice a week. In the past year, no inpatient hospitalizations and no more than two outpatient or urgent care visits for exacerbations. Oral corticosteroids for flare-ups are limited to two courses per year. Inhaled corticosteroids, short- and long-acting beta agonists, and leukotriene receptor antagonists such as montelukast are acceptable. Monoclonal antibodies are not acceptable for CACI.³
Glaucoma: formal visual field testing is required, specifically a Humphrey 24-2 or 30-2 (SITA or full threshold) or an Octopus test (TOP or full threshold). Confrontation or screening visual field tests are not accepted, and results must show no visual field defect.⁴
Prediabetes: if your A1C has ever reached 6.5 percent or higher, the prediabetes CACI cannot be used. The application would go through the diabetes pathway instead.⁵

Renewal cadence also lives on the worksheet. For asthma, first- and second-class applicants must provide updated documentation annually; third-class applicants provide it at each required exam.³ Other conditions follow their own schedules, so check yours.

Your Medication List

Prepare a complete list of every medication you take, with dosages and any side effects. Cross-reference each drug against the acceptable list on your worksheet. The FAA publishes approved-medication lists on its AME Guide website for conditions like hypertension.⁶ A medication that controls your condition well but isn’t on the approved list will still trigger a deferral.

Fill Out Form 8500-8 Through MedXPress

Before your appointment, submit FAA Form 8500-8 (Application for Airman Medical Certificate) through MedXPress at medxpress.faa.gov. A valid email address is all you need to create an account. MedXPress covers items 1 through 20 of the form: personal information, medical history, and flight experience. Filling it in online shortens the office visit.⁷

Answer every medical history question honestly. Omitting a condition or medication creates far worse problems than disclosing one. The FAA cross-references records, and a later discovery of an undisclosed condition can lead to certificate revocation and enforcement action. Disclosing a CACI-eligible condition is precisely how you access the streamlined pathway in the first place.

Find an AME through the FAA’s designee locator at designee.faa.gov/designeeLocator.⁸ When you book, say you have a CACI-eligible condition and ask for enough time to review documentation. A short slot is not built for a worksheet review.

What Happens at the AME Visit

The AME performs the standard physical exam and then works through your CACI documentation against the worksheet: progress note within 90 days, lab results within acceptable ranges, medications on the approved list, no disqualifying complications. If every item checks out, the AME issues your medical certificate that same visit.¹ A CACI-issued certificate is unrestricted; it carries no special limitations or shortened duration beyond the standard regulatory validity for your class of medical.

AME exam fees are not set by the FAA and vary by examiner and region. Expect a few hundred dollars out of pocket.

If the AME Can’t Issue

Miss even one worksheet requirement and the AME cannot issue. The exam is deferred, and your documents go to the FAA’s Aerospace Medical Certification Division or Regional Flight Surgeon for individual review.¹ A deferral isn’t a denial. It means the AME wasn’t authorized to make the call.

Deferred applications can take several months, and incomplete submissions extend that timeline. The FAA may request additional documentation, specialist evaluations, or updated testing. If the FAA ultimately finds you don’t meet medical standards, that is a formal denial, and you can request reconsideration by the Federal Air Surgeon within 30 days.⁹

Most deferrals come from preparation gaps: a progress note older than 90 days, missing lab results, a medication not on the approved list, or a clinical value outside the acceptable range. All of these are avoidable with a careful pre-visit review. If a parameter is borderline, say a blood pressure reading of 153/94, consider a follow-up with your treating physician before the AME visit to bring it comfortably within range.

Your Duty Between Exams

Getting a certificate through CACI does not end your obligations. Under 14 CFR 61.53, you cannot act as pilot in command or serve as a required flight crewmember if you know or have reason to know of a medical condition that would prevent you from meeting the standards for your medical certificate.¹⁰ If your CACI condition worsens, such as asthma requiring hospitalization, blood pressure spiking despite medication, or a new complication from a previously stable cancer, you must ground yourself until it’s back under control.

The self-assessment duty is continuous. A pilot who knows their A1C has climbed above the CACI threshold and keeps flying is violating federal regulations regardless of the unexpired certificate in their wallet. Once the condition stabilizes, bring updated documentation to your next AME visit and run through the CACI process again.

When CACI Isn’t the Right Route

If your condition isn’t on the CACI list, or it is on the list but you can’t meet the worksheet parameters, the AME defers to the FAA and your application enters the Special Issuance Authorization process. Special Issuance results in a time-limited certificate with follow-up requirements set by the FAA.¹¹

BasicMed is a separate pathway that skips AME certification entirely. You see your personal physician, complete an online medical education course, and fly under operational limitations: no flights above 18,000 feet, no more than six passengers, aircraft under 6,000 pounds. For recreational flying with a stable condition, BasicMed can be simpler. But if you need an unrestricted medical certificate for commercial or airline transport operations, CACI is the streamlined route when your condition qualifies.

1
Federal Aviation Administration. Guide for Aviation Medical Examiners – CACI Conditions
2
Federal Aviation Administration. CACI – Hypertension Worksheet
3
Federal Aviation Administration. CACI – Asthma Worksheet
4
Federal Aviation Administration. CACI – Glaucoma Worksheet
5
Federal Aviation Administration. CACI – Prediabetes Worksheet
6
Federal Aviation Administration. Guide for Aviation Medical Examiners – Item 36 Heart – Hypertension
7
Federal Aviation Administration. Medical Certification
8
Federal Aviation Administration. Find an Aviation Medical Examiner (AME)
9
Federal Aviation Administration. Guide for Aviation Medical Examiners – Appeals and Authorization
10
eCFR. 14 CFR 61.53 – Prohibition on Operations During Medical Deficiency
11
Federal Aviation Administration. Guide for Aviation Medical Examiners – Special Issuances, AASI for All Classes