The Civil Aviation Act 2023 came into force on 5 April 2025. We have a new set of forms for use after this date.
Application for a medical certificate (24067-001) [PDF 2.2 MB]
Medical examination report (24067-002) [PDF 83 KB]
Medical assessment report (24067-003) [PDF 1.6 MB]
General direction submission form (24067-004) [DOC 73 KB]
Electrocardiograph request (24067-202) [DOCX 34 KB]
Audiometry report (24067-203) [PDF 220 KB]
In flight hearing assessment report (24067-204) [PDF 115 KB]
Special eye report (24067-211) [PDF 2.5 MB]
Operational colour vision assessment - Word version (24067-212) [DOCX 39 KB]
Respiratory examination report (24067-213) [DOCX 39 KB]
Blood pressure examination report (24067-214) [DOCX 43 KB]
Headache/migraine investigation report (24067-215) [PDF 410 KB]
Diabetes report (24067-216) [PDF 332 KB]
Ageing pilot report (24067-217) [PDF 148 KB]
Suspension of certificate - PDF version (24067-401) [PDF 1.4 MB]
Suspension of certificate - Word version (24067-401) [DOCX 46 KB]
Restriction of certificate (24067-402) [DOCX 44 KB]
Withdrawal of conditions, restrictions and endorsements (24067-403) [DOCX 81 KB]
Cancellation of suspension of certificate (24067-404) [DOCX 41 KB]
Extension of suspension of certificate (24067-405) [DOCX 42 KB]
Extension of restriction of certificate (24067-406) [DOCX 42 KB]
Application for replacement of a medical certificate (24067-407) [DOCX 295 KB]
Fit and proper person questionnaire – Medical Examiner designation (24067-502) [PDF 136 KB]
If you have any questions about this topic, use our contact form, or email med@caa.govt.nz.
