JAR FCL Med Cert Class 1

Statens Luftfartsvæsen
Civil Administration – Denmark
I
III
IV
V
Udstedelsesland/State of Licence Issue
Danmark/Denmark
Referencenummer/Reference No
(first letters): Country Code
IX
Helbredsgodkendelse klasse 1/2/
Medical Certificate Class 1/2
Udløbsdato/Expiry date of this certificate:
Class 1
Class 1 (SP)
Class 2
Indehaverens efter- og fornavn/
Last and first name(s) of holder
XIII
Adresse/Address
Undersøgelsesdato/
Examination date:
Udløbsdato for seneste helbredsgodkendelse/
Expiry date of previous Medical Certificate:
Vejledende information/
Advisory Information:
Begrænsninger/Limitations
Sidste
Most
recent
Næste/
Next:
Elektrocardiogram/
Elektrocardiogram
HELBREDSGODKENDELSE KL. 1/2
MEDICAL CERTIFICATE CLASS 1/2
Audiogram/
Audiogram:
XIV
Fødselsdato/ Date of Birth:
VI
Nationalitet/ Nationality:
VII
Indehaverens underskrift/
Signature of holder:
Bemærkninger/Comments:
X
Dato og udsteders underskrift/
Date of issue and signature of issuing officer:
XI
Stempel/Stamp:
ISSUED IN ACCORDANCE WITH ICAO
STANDARDS AND JAR-FCL 3
Fold her
Holders of medical certificates shall without undue
delay, seek the advice of an AM an AMC or the AMS
when becoming aware of:

hospital or clinic admission for more than
12 hours; or

surgical operation or invasive procedure; or
the regular use of medication; or(4) the need for
regular use or correcting lense
Holders of medical certificates who are aware of:

any significant personal injury involving
incapacity to function as a member of a
flight crew; or

any illness involving incapacity to function
as a member of a flight crew throughout a
period of 21 days or more; or

being pregnant,
shall inform the AME
MEDICAL CERTIFICATION
Class 1
Licence
Class 1
Validity of Medical Certificate
Under age 60: 12 months
(Max 45 days before
Age 40 – 59 (SP) 6 months
revalidation)
Age 60 and over: 6 months
Haemoglobin
Every examination
Electrocardiogram
Under age 30
5 yearly
Age 30 - 39
2 yearly
Age 40 and over Annually
MEDICAL CERTIFICATION
Class 2
Licence
Class 2
Validity of Medical Certificate
Under age 40: 60 months
(Max 45 days before
Max age 42:
revalidation)
Age 40 – 49:
24 months
Age 50 and over: 12 months
Haemoglobin
If indicated
Electrocardiogram
Age 40 - 49
2 yearly
Age 50 and over Annually
Audiogram
Under age 40
5 yearly
Age 40 and over 2 yearly
Audiogram
For instrument Rating only:
Under age40
5 yearly
Age 40 and over 2 yearly
Comprehensive ORL
Initial then if indicated
Ophthalmology Examination
At initial by AME or specialist
Ophthalmology
Initial: Specialist
If refr.error > +/- 3dptr::
Specialist.
If refr.error > +3 to +5 dptr or >
-3 to -6 dptr: Specialist rep. 5
yearly.
Initial then age 40
Lipid profile
If two or more risk factors are
identified at initial and then
age 40
Pulmonary Function
Test
If indicated
Urinalysis
At initial then every
examination
Lipid profile
Pulmonary Function
Test
Initial then if indicated
Urinalysis
Every examination
Code
TML
VDL
VML
VNL
VCL
OML
OFL
OCL
OSL
OAL
OPL
APL
AHL
AGL
SSL
SIC
AMS
REV
RXO
Limitation, Condition, Variation
Valid only for …. Months
Shall wear corrective lenses and carry a spare
set of spectacles
Shall wear multifocal lenses and carry a spare
set of spectacles
Shall have available corrective spectacles for
near vision and carry a spare set of spectacles
Valid by day only
Valid only as or with qualified co-pilot
Class 1 valid for flight engineer duties only
Valid only as co-pilot
Valid only with safety pilot and I aircraft with
dual controls
Restricted to demonstrated aircraft type
Valid only without passengers
Valid only with approved prosthesis
Valid only with approved hand controls
Valid only with approved eye protection
Special restrictions as specified
Special instructions – Contact AMS
Recertification ir renewal only by AMS
Medical Certificate issued after review procedure.
Special instructions may apply. AMS may be
contacted
Requires specialist ophthalmological examinations