Clearance For Pilots / US Military Personnel

*Please note that requests require seven (7) business days of processing time.

"*" indicates required fields

Patient Name*

Date of Birth*

Phone*

Email*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Notes

Please attach FAA form or Doctor's Clearance Request here

Max. file size: 50 MB.