ACO Av Med Form 1
OFFICIAL - SENSITIVE - MEDICAL (WHEN COMPLETE)
CONDITIONS REQUIRING MEDICAL ASSESSMENT FOR VGS GLIDING/AEF FLYING
TO COMPLETE TICK RESPONSE Y/N
CONDITION OR EVENT
Y/N
IF YES
COMMENTS - FURTHER GUIDANCE
Recent immunisations or blood donation
No
Yes
DO NOT FLY WITHIN 24HRS OF
TREATMENT
Compatible with RA2135
Acute illness (or flare of chronic
condition) or new treatment
No
Yes
DO NOT FLY UNTIL RECOVERED
Compatible with RA2135
Acute injury limiting mobility or use of
limbs
ENT or sinus conditions
No
Yes
DO NOT FLY UNTIL RECOVERED
Unnecessary risk, limiting emergency drills.
No
Yes
DO NOT FLY UNTIL RECOVERED
Cadets are to be able to safely tolerate barometric changes.
Pregnancy
No
Yes
DO NOT FLY
Probably safe but risks blame for any subsequent miscarriage. Serving
aircrew grounded iaw AP1269A Lflt 5-162. Risk assessment in JSP 950 67-5 Annex J Appendix 1
Any condition that requires oxygen
therapy
No
Yes
DO NOT FLY
Adverse effect of altitude. Integration of medical eqpt into cockpit. CAA
Guidelines
Unstable or brittle medical condition
No
Yes
DO NOT FLY
Limited exercise capacity/tolerance due
to chest (heart or lung) illness or disease
No
Yes
DO NOT FLY
Fits, faints, blackouts (including epilepsy)
No
Yes
DO NOT FLY
Unreasonable to fly anyone with a predictable risk of incapacitation
within the timescale of flight (or symptoms brought on by stressors of
flight)
The most practical fitness to fly test for heart/lung disease is to assess
whether the patient can walk 50 yards/metres at a normal pace or climb
one flight of stairs without severe breathlessness. If this can be
accomplished, it is likely that the patient will tolerate the normal aircraft
environment. (CAA)
Cadet strapped sitting upright; no first aid available in flight. Risk of
confusion/ impaired behaviour post-recovery.
Recent surgery or anaesthetic (any)
No
Yes
Risk from trapped gas, limited mobility, wound opening, pain.
Pneumothorax
No
Yes
Acute, unstable or untreated psychiatric
conditions, including fear of flying &
claustrophobia
No
Yes
DO NOT FLY UNTIL FULLY RECOVERED MINIMUM 7 DAYS
DO NOT FLY FOR 1 MONTH FROM LAST
TREATMENT
DO NOT FLY UNTIL TREATED AND
SYMPTOMS STABLE
Any stable chronic disease not covered
above
No
Yes
START F6424 PROCEDURE - RISK ASSESS
GP / CFMO
Stable disease may be acceptable for short pax flight if activities of daily
living are not unduly impaired
Any disease with sudden or unpredictable
onset or deterioration
Asthma STEP 15
No
Yes
No
Yes
START F6424 PROCEDURE - RISK ASSESS
GP / CFMO
FIT TO FLY IF CONDITIONS STABLE MUST CARRY MEDICATION IN FLIGHT
Asthma STEP 2 or higher5
No
Yes
Diabetes Type 1: Acceptable if well
controlled.
Diabetes Type 2
No
Yes
No
Yes
START F6424 PROCEDURE - RISK ASSESS
GP / CFMO
FIT TO FLY IF CONDITIONS STABLE MUST CARRY GLUCOSE IN FLIGHT
FIT TO FLY
The risk of sudden incapacitation (spontaneous or precipitated by flight
environment) should be risk assessed against proposed flight profile.
Acceptable for passenger flight if medication available and disease
stable (occasional inhaler use; no rescue medication (eg steroids,
antibiotics) in last month)
More severe disease may be acceptable for ghosted solo standard, iaw
AP1269A Lflt .
Type 1 acceptable if blood sugars are well controlled. Insulin pump (if
used) should be integrated with AEA. Check sugars prior to flight.
Acceptable.
Haematological (blood) disorders
No
Yes
START F6424 PROCEDURE - RISK ASSESS
GP / CFMO
Any disorder of coagulation (whether constitutional or acquired) should
be carefully risk assessed. Severe anaemia (<9) is unfit until treated.
Migraines
No
Yes
Cognitive, emotional, behavioural or
developmental conditions (including
ADHD, conduct disorders, dyspraxia and
autism spectrum disorders)
Stable injury, illness or condition limiting
mobility or use of limbs
No
Yes
RISK ASSESS. DO NOT FLY WITH
SYMPTOMS OR ATTACK CAN OCCUR
WITHIN FLIGHT TIMEFRAME
START F6424 PROCEDURE - RISK ASSESS
GP / CFMO
No
Yes
START F6424 PROCEDURE - RISK ASSESS
GP / CFMO
Do not fly with symptoms. Do not fly if typical attack can occur within
the timeframe of flight. Visual or neurological symptoms of particular
concern.
Cadets are to understand and follow clear instruction. Any condition,
whether treated or not, should not be so severe as to impair
understanding of emergency drills or lead to behaviour that would
endanger the aircraft.
Consider cockpit assessment and integration check with AEA. Special
consideration of effect on emergency egress.
Stable psychiatric disorders
No
Yes
START F6424 PROCEDURE - RISK ASSESS
GP / CFMO
Assess likely behaviour in-flight: consider risk to person and aircraft
Severe allergy (including epipen or
equivalent)
No
Yes
FIT TO FLY IF CONDITIONS ACCEPTABLE SEE COMMENTS. MUST CARRY
MEDICATION IN FLIGHT
If generally stable, with a clearly identified allergen that is avoidable
then fit to fly. Very severe, unstable or unpredictable reactions are
unfit. Those likely to be exposed to allergen (eg plastics, rubbers) in
flight are unfit.
Risk from trapped gas
Behaviour in-flight: risk to person and aircraft
Further Information
Cadet Name:
Sqn
Wing:
Signature of Cadet
Date
Declaration: I hereby declare that I have carefully considered the statements made above and that to the best of my belief they are complete and correct and that I have not withheld
any relevant information or made any misleading statements. I also confirm that should the cadets medical history change since the medical examination above, I will ensure that the
relevant ATC Sqn OC / CCF (RAF) Section Cdr is informed and a new ACO Av Med Form 1 is produced.
Parent/Guardian Signature
(Paper) VER 1.01
PERIOD OF VALIDITY: VALID FOR THREE MONTHS FROM DATE OF DECLARATION
:
GUIDANCE NOTES FOR COMPLETION ACO Av Med Form 1
1. Certain medical and physical conditions are incompatible with flying as they could place the cadet at risk and compromise Air Safety. A
list of medical conditions incompatible with gliding/flying training or which may require further medical scrutiny can be found in ACO Av
Med Form 1 - Conditions Requiring Medical Assessment for VGS Gliding/AEF Flying.
2. The ACO Av Med Form 1 should be completed by ticking either Yes or No to the question asked. The disposal field advises of the actions
which may be required to gain medical clearance if any responses are Yes .
3. The applicant should complete, in full, all questions (sections) on the form. Failure to complete the form in full will result in nonacceptance of the form.
4. The ACO Av Med Form 1 must be signed by you and your parent/guardian (if under 18 years of age) to validate the certificate.
6. To satisfy gliding/flying medical requirements, cadets must be in possession of a completed ACO Av Med Form 1. Failure to be in the
possession of a completed and signed Av Med Form 1 will invalidate the eligibility of a cadet to undertake gliding training. VGS/AEF staff
are directed to refuse flying training to cadets not in possession of the relevant signed forms at the point of delivery.
7. Period of validity: Although this declaration is valid for three months from the date of signing, it is immediately invalidated should any
change in fitness or health occur.
8. Reduction in Medical Fitness: If referred for a medical investigation or procedure, or after any serious illness or injury, you must reassess
your medical fitness to fly. It is your responsibility to ensure that a new ACO Av Med Form 1 completed before undertaking aviation
activity.
9. Corrective lenses If you wear spectacles or contact lenses a readily available spare pair of spectacles must be carried when flying.
10. After Signing: Cadets are to hand the ACO Av Med Form 1 to your ATC Sqn OC / CCF (RAF) Section Cdr for scrutiny.
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