Appendix V to ANNEX VI (Part-ARA) - Certificate for Aeromedical Centres (AeMCs)

• Regulation (EU) No 245/2014 found in: Aircrew (1178/2011) Part-FCL Part-MED Part-CC Part-ARA Part-ORA Part-DTO (Aug 2023)
• Regulation (EU) 2024/2076 found in: Aircrew (1178/2011) Part-FCL Part-MED Part-CC Part-ARA Part-ORA Part-DTO (Dec 2024)

Appendix V to ANNEX VI (Part-ARA) – Certificate for Aeromedical Centres (AeMCs) Regulation (EU) No 245/2014 CERTIFICATE FOR AERO-MEDICAL CENTRES (AeMCs) European Union[**[26]**](#_ftn26) Competent Authority AERO-MEDICAL CENTRE CERTIFICATE REFERENCE: Pursuant to Commission Regulation (EU) No 1178/2011 and subject to the conditions specified below, the [competent authority] hereby certifies [NAME OF THE ORGANISATION] [ADDRESS OF THE ORGANISATION] As Part-ORA certifies Aero-medical centre with the privileges and the scope of activities as listed in the attached terms of approval. CONDITIONS: 1. This certificate is limited to that specified in the scope of approval section of the approved organisation manual; 2. This certificate requires compliance with the procedures specified in the organisation documentation as required by Part-ORA. 3. This certificate shall remain valid subject to compliance with the requirements of Part-ORA unless it has been surrendered, superseded, suspended or revoked. Date of issue: …………………………………………………………………. Signature: …………………………………………………………… EASA Form 146 Issue 1 --- [[26]](#_ftnref26) 'European Union' to be deleted for non-EU Member States Appendix V to ANNEX VI (Part-ARA) – Certificate for Aeromedical Centres (AeMCs) Regulation (EU) 2024/2076 CERTIFICATE FOR AERO-MEDICAL CENTRES (AeMCs) European Union[**[29]**](#_ftn29) Competent Authority AERO-MEDICAL CENTRE CERTIFICATE REFERENCE: Pursuant to Commission Regulation (EU) No 1178/2011 and subject to the conditions specified below, the [competent authority] hereby certifies [NAME OF THE ORGANISATION] [ADDRESS OF THE ORGANISATION] As Part-ORA certifies Aero-medical centre with the privileges and the scope of activities as listed in the attached terms of approval. CONDITIONS: 1.          This certificate is limited to that specified in the scope of approval section of the approved organisation manual; 2.          This certificate requires compliance with the procedures specified in the organisation documentation as required by Part-ORA. 3.          This certificate shall remain valid subject to compliance with the requirements of Part-ORA unless it has been surrendered, superseded, suspended or revoked. Date of issue: …………………………………………………………………. Signature: …………………………………………………………… EASA Form 146 Issue 1 [applicable until 12 February 2025 - Regulation (EU) 245/2014] CERTIFICATE FOR AERO-MEDICAL CENTRES (AeMCs) European Union[**[30]**](#_ftn30) Competent Authority AERO-MEDICAL CENTRE CERTIFICATE REFERENCE: Pursuant to Commission Regulation (EU) No 1178/2011 and Regulation (EU) 2015/340 ([[31]](#_ftn31)) and subject to the conditions specified below, the [competent authority] hereby certifies [NAME OF THE ORGANISATION] [ADDRESS OF THE ORGANISATION] as a Part-ORA certified Aero-medical centre with the privileges and the scope of activities as listed in the attached terms of approval. CONDITIONS: 1.       This certificate is limited to that specified in the scope of approval section of the approved organisation manual; 2.       This certificate requires compliance with the procedures specified in the organisation documentation as required by Part- ORA. 3.       This certificate shall remain valid subject to compliance with the requirements of Part-ORA unless it has been surrendered, superseded, suspended or revoked. Date of issue: dd/mm/yyyy: …………………………………………………………………. Signature: [Competent Authority]: …………………………………………………………… EASA Form 146 Issue 2 AERO-MEDICAL CENTRE CERTIFICATE Attachment ([[32]](#_ftn32)) to AeMC certificate number: PRIVILEGES AND SCOPE [Name of the organisation] has obtained the privilege(s) to undertake aero-medical examinations and assessments for the issuance of medical certificates and medical reports as stated in the table below and to issue these medical certificates and medical reports for: <table border="1" cellpadding="0" cellspacing="0"> <tr> <td valign="top" width="200"> <p></p> </td> <td valign="top" width="200"> <p><b>Initial/revalidation/renewal</b></p> </td> <td valign="top" width="200"> <p><b>Date of issue</b></p> </td> </tr> <tr> <td valign="top" width="200"> <p><b>Class 1</b></p> </td> <td valign="top" width="200"> </td> <td valign="top" width="200"> </td> </tr> <tr> <td valign="top" width="200"> <p><b>Class 2/LAPL/Cabin Crew</b></p> </td> <td valign="top" width="200"> </td> <td valign="top" width="200"> </td> </tr> <tr> <td valign="top" width="200"> <p><b>Class 3 (<a href="#_ftn33"><b>[33]</b></a>)</b></p> </td> <td valign="top" width="200"> </td> <td valign="top" width="200"> </td> </tr> </table> Date of issue: dd/mm/yyyy: …………………………………………………………………. Signature: [Competent Authority]: …………………………………………………………… *[applicable from 13 February 2025 - Regulation (EU) 2024/2076]* --- [[29]](#_ftnref29)    'European Union' to be deleted for non-EU Member States [[30]](#_ftnref30) 'European Union' to be deleted for non-EU Member States or EASA. [[31]](#_ftnref31) Reference to Regulation (EU) No 1178/2011 or Regulation (EU) 2015/340 shall be modified as per the certificate’s scope. [[32]](#_ftnref32) Class 3 shall be added only for the AeMCs approved to perform class 3 aero-medical examinations. [[33]](#_ftnref33) Class 3 shall be added only for the AeMCs approved to perform class 3 aero-medical examinations. #### Appendix V to ANNEX VI (Part-ARA) – Certificate for Aeromedical Centres (AeMCs) *Regulation (EU) 2024/2076* **CERTIFICATE FOR AERO-MEDICAL CENTRES (AeMCs)** **European Union** ([[32]](#_ftn32)) **Competent Authority** **AERO-MEDICAL CENTRE CERTIFICATE** REFERENCE: Pursuant to Commission Regulation (EU) No 1178/2011 and Regulation (EU) 2015/340 ([[33]](#_ftn33)) and subject to the conditions specified below, the [competent authority] hereby certifies [NAME OF THE ORGANISATION] [ADDRESS OF THE ORGANISATION] as a Part-ORA certified Aero-medical centre with the privileges and the scope of activities as listed in the attached terms of approval. CONDITIONS: 1. This certificate is limited to that specified in the scope of approval section of the approved organisation manual; 2. This certificate requires compliance with the procedures specified in the organisation documentation as required by Part- ORA. 3. This certificate shall remain valid subject to compliance with the requirements of Part-ORA unless it has been surrendered, superseded, suspended or revoked. Date of issue: dd/mm/yyyy: …………………………………………………………………. Signature: [Competent Authority]: …………………………………………………………… EASA Form 146 Issue 2 **AERO-MEDICAL CENTRE CERTIFICATE** Attachment ([[34]](#_ftn34)) to AeMC certificate number: **PRIVILEGES AND SCOPE** [Name of the organisation] has obtained the privilege(s) to undertake aero-medical examinations and assessments for the issuance of medical certificates and medical reports as stated in the table below and to issue these medical certificates and medical reports for: <table bgcolor="#d9d9d9" cellpadding="7" cellspacing="0"> <col/> <col/> <col/> <tr valign="top"> <td bgcolor="#808080"><p align="left"> <br/> </p> </td> <td bgcolor="#808080"><p align="left"> <b>Initial/revalidation/renewal</b></p> </td> <td bgcolor="#808080"><p align="left"> <b>Date of issue</b></p> </td> </tr> <tr valign="top"> <td bgcolor="#808080"><p align="left"> <b>Class 1</b></p> </td> <td bgcolor="#d9d9d9"><p align="left"> <br/> </p> </td> <td bgcolor="#d9d9d9"><p align="left"> <br/> </p> </td> </tr> <tr valign="top"> <td bgcolor="#808080"><p align="left"> <b>Class 2/LAPL/Cabin Crew</b></p> </td> <td bgcolor="#d9d9d9"><p align="left"> <br/> </p> </td> <td bgcolor="#d9d9d9"><p align="left"> <br/> </p> </td> </tr> <tr valign="top"> <td bgcolor="#808080"><p align="left"> <b>Class 3 ⁽<a href="#_ftn35" name="_ftnref35">[35]</a>⁾</b></p> </td> <td bgcolor="#d9d9d9"><p align="left"> <br/> </p> </td> <td bgcolor="#d9d9d9"><p align="left"> <br/> </p> </td> </tr> </table> Date of issue: dd/mm/yyyy: …………………………………………………………………. Signature: [Competent Authority]: …………………………………………………………… --- [[32]](#_ftnref32) 'European Union' to be deleted for non-EU Member States or EASA. [[33]](#_ftnref33) Reference to Regulation (EU) No 1178/2011 or Regulation (EU) 2015/340 shall be modified as per the certificate’s scope. [[34]](#_ftnref34) Class 3 shall be added only for the AeMCs approved to perform class 3 aero-medical examinations. [[35]](#_ftnref35) Class 3 shall be added only for the AeMCs approved to perform class 3 aero-medical examinations.