Appendix VII to ANNEX VI (Part-ARA) - Certificate for Aeromedical Examiners (AMEs)

• Regulation (EU) No 290/2012 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 VII to ANNEX VI (Part-ARA) – Certificate for Aeromedical Examiners (AMEs) Regulation (EU) No 290/2012 CERTIFICATE FOR AERO-MEDICAL EXAMINERS (AMEs) European Union[**[27]**](#_ftn27) Competent Authority AERO-MEDICAL EXAMINER CERTIFICATE CERTIFICATE NUMBER/REFERENCE: Pursuant to Commission Regulation (EU) No 1178/2011 and subject to the conditions specified below, the [competent authority] hereby certifies [NAME OF THE AERO-MEDICAL EXAMINER] [ADDRESS OF THE AERO-MEDICAL EXAMINER] as aero-medical examiner CONDITIONS: 1. This certificate is limited to the privileges specified in the attachment to this AME certificate; 2. This certificate requires compliance with the implementing rules and procedures specified in Part-MED. 3. This certificate shall remain valid for a period of 3 years until [xx/yy/zzzz[[28]](#_ftn28)] subject to compliance with the requirements of Part-MED unless it has been surrendered, superseded, suspended or revoked. Date of issue: xx/yy/zzzz Signature: [Competent Authority] EASA Form 148 Issue 1 AERO-MEDICAL EXAMINER CERTIFICATE Attachment to AME certificate number: PRIVILEGES AND SCOPE [Name and academic title of the aero-medical examiner] has obtained the privilege(s) to undertake aero-medical examinations and assessments for the issuance of medical certificates as stated in the table below and to issue these medical certificates for: <table border="1" cellpadding="0" cellspacing="0"><tr><td width="299"><p>LAPL</p></td><td width="299"><p>[yes/date]</p></td></tr><tr><td width="299"><p>Class 2</p></td><td width="299"><p>[yes/date]</p></td></tr><tr><td width="299"><p>Class 1 revalidation /renewal</p></td><td width="299"><p>[yes/date]/[no]</p></td></tr></table> Date of issue: xx/yy/zzzz Signature: [Competent Authority] --- [[27]](#_ftnref27) 'European Union' to be deleted for non-EU Member States [[28]](#_ftnref28) Expiry date: day/month/year Appendix VII to ANNEX VI (Part-ARA) – Certificate for Aeromedical Examiners (AMEs) Regulation (EU) 2024/2076 CERTIFICATE FOR AERO-MEDICAL EXAMINERS (AMEs) European Union[**[34]**](#_ftn34) Competent Authority AERO-MEDICAL EXAMINER CERTIFICATE CERTIFICATE NUMBER/REFERENCE: Pursuant to Commission Regulation (EU) No 1178/2011 and subject to the conditions specified below, the [competent authority] hereby certifies [NAME OF THE AERO-MEDICAL EXAMINER] [ADDRESS OF THE AERO-MEDICAL EXAMINER] as aero-medical examiner CONDITIONS: 1.          This certificate is limited to the privileges specified in the attachment to this AME certificate; 2.          This certificate requires compliance with the implementing rules and procedures specified in Part-MED. 3.          This certificate shall remain valid for a period of 3 years until [xx/yy/zzzz[[35]](#_ftn35)] subject to compliance with the requirements of Part-MED unless it has been surrendered, superseded, suspended or revoked. Date of issue: xx/yy/zzzz                                                                              Signature: [Competent Authority] EASA Form 148 Issue 1 AERO-MEDICAL EXAMINER CERTIFICATE Attachment to AME certificate number: PRIVILEGES AND SCOPE [Name and academic title of the aero-medical examiner] has obtained the privilege(s) to undertake aero-medical examinations and assessments for the issuance of medical certificates as stated in the table below and to issue these medical certificates for: <table border="1" cellpadding="0" cellspacing="0"> <tr> <td width="299"> <p>LAPL</p> </td> <td width="299"> <p>[yes/date]</p> </td> </tr> <tr> <td width="299"> <p>Class 2</p> </td> <td width="299"> <p>[yes/date]</p> </td> </tr> <tr> <td width="299"> <p>Class 1 revalidation /renewal</p> </td> <td width="299"> <p>[yes/date]/[no]</p> </td> </tr> </table> Date of issue: xx/yy/zzzz                                                                              Signature: [Competent Authority] [applicable until 12 February 2025 - Regulation (EU) 290/2012] CERTIFICATE FOR AERO-MEDICAL EXAMINERS (AMEs) European Union[**[36]**](#_ftn36) Competent Authority AERO-MEDICAL EXAMINER CERTIFICATE CERTIFICATE NUMBER/REFERENCE: Pursuant to Commission Regulation (EU) No 1178/2011 and Regulation (EU) 2015/340 ([[37]](#_ftn37)) and subject to the conditions specified below, the [competent authority] hereby certifies [NAME OF THE AERO-MEDICAL EXAMINER] [PRACTICE ADDRESS(ES) OF THE AERO-MEDICAL EXAMINER] as aero-medical examiner CONDITIONS: 1.       This certificate is limited to the privileges specified in the attachment to this AME certificate; 2.       This certificate requires compliance with the implementing rules and procedures specified in Part-MED/Part ATCO.MED ([[38]](#_ftn38)). 3.       This certificate shall remain valid from [dd/mm/yyyy] until [dd/mm/yyyy ([[39]](#_ftn39))] subject to compliance with the requirements of Part-MED/Part ATCO.MED (2) unless it has been surrendered, superseded, suspended or revoked. Date of issue: dd/mm/yyyy                                                                         Signature: [Competent Authority] EASA Form 148 Issue 2 AERO-MEDICAL EXAMINER CERTIFICATE Attachment([[40]](#_ftn40)) to AME certificate number: PRIVILEGES AND SCOPE [Name and academic title of the aero-medical examiner] 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 width="299"> <p>Class 1 revalidation/renewal</p> </td> <td width="299"> <p>[valid until]/[Not Applicable]</p> </td> </tr> <tr> <td width="299"> <p>Class 2/LAPL/Cabin crew Initial/revalidation/renewal</p> </td> <td width="299"> <p>[valid until]</p> </td> </tr> <tr> <td width="299"> <p>Class 3 (<a href="#_ftn41">[41]</a>) revalidation/renewal</p> </td> <td width="299"> <p>[valid until]/[Not Applicable]</p> </td> </tr> </table> Date of issue: dd/mm/yyyy                                                                         Signature: [Competent Authority] *[applicable from 13 February 2025 - Regulation (EU) 2024/2076]* --- [[34]](#_ftnref34)    'European Union' to be deleted for non-EU Member States [[35]](#_ftnref35)    Expiry date: day/month/year [[36]](#_ftnref36) 'European Union' to be deleted for non-EU Member States [[37]](#_ftnref37) Reference to Regulation (EU) No 1178/2011 or Regulation (EU) 2015/340 as well as Part-MED and Part ATCO.MED shall be modified as per the certificate’s scope. [[38]](#_ftnref38) Reference to Regulation (EU) No 1178/2011 or Regulation (EU) 2015/340 as well as Part-MED and Part ATCO.MED shall be modified as per the certificate’s scope. [[39]](#_ftnref39) Expiry date format: day/month/year. [[40]](#_ftnref40) This attachment may be issued as part of the AME certificate or as a separate document. [[41]](#_ftnref41) Class 3 shall be added only for the AMEs approved to perform class 3 aero-medical examinations. #### Appendix VII to ANNEX VI (Part-ARA) – Certificate for Aeromedical Examiners (AMEs) *Regulation (EU) 2024/2076* **CERTIFICATE FOR AERO-MEDICAL EXAMINERS (AMEs)** **European Union ([[36]](#_ftn36))** **Competent Authority** **AERO-MEDICAL EXAMINER CERTIFICATE** CERTIFICATE NUMBER/REFERENCE: Pursuant to Commission Regulation (EU) No 1178/2011 and Regulation (EU) 2015/340 ([[37]](#_ftn37)) and subject to the conditions specified below, the [competent authority] hereby certifies [NAME OF THE AERO-MEDICAL EXAMINER] [PRACTICE ADDRESS(ES) OF THE AERO-MEDICAL EXAMINER] as aero-medical examiner CONDITIONS: 1. This certificate is limited to the privileges specified in the attachment to this AME certificate; 2. This certificate requires compliance with the implementing rules and procedures specified in Part-MED/Part ATCO.MED ([[38]](#_ftn38)). 3. This certificate shall remain valid from [dd/mm/yyyy] until [dd/mm/yyyy ([[39]](#_ftn39))] subject to compliance with the requirements of Part-MED/Part ATCO.MED (2) unless it has been surrendered, superseded, suspended or revoked. Date of issue: dd/mm/yyyy Signature: [Competent Authority] EASA Form 148 Issue 2 **AERO-MEDICAL EXAMINER CERTIFICATE** Attachment ([[40]](#_ftn40)) to AME certificate number: PRIVILEGES AND SCOPE [Name and academic title of the aero-medical examiner] 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 cellpadding="7" cellspacing="0"> <col/> <col/> <tr> <td><p align="left"> Class 1 revalidation/renewal</p> </td> <td><p align="left"> [valid until]/[Not Applicable]</p> </td> </tr> <tr> <td><p align="left"> Class 2/LAPL/Cabin crew Initial/revalidation/renewal</p> </td> <td><p align="left"> [valid until]</p> </td> </tr> <tr> <td><p align="left"> Class 3 ⁽<a href="#_ftn41" name="_ftnref41">[41]</a>⁾ revalidation/renewal</p> </td> <td><p align="left"> [valid until]/[Not Applicable]</p> </td> </tr> </table> Date of issue: dd/mm/yyyy Signature: [Competent Authority] --- [[36]](#_ftnref36) 'European Union' to be deleted for non-EU Member States [[37]](#_ftnref37) Reference to Regulation (EU) No 1178/2011 or Regulation (EU) 2015/340 as well as Part-MED and Part ATCO.MED shall be modified as per the certificate’s scope. [[38]](#_ftnref38) Reference to Regulation (EU) No 1178/2011 or Regulation (EU) 2015/340 as well as Part-MED and Part ATCO.MED shall be modified as per the certificate’s scope. [[39]](#_ftnref39) Expiry date format: day/month/year. [[40]](#_ftnref40) This attachment may be issued as part of the AME certificate or as a separate document. [[41]](#_ftnref41) Class 3 shall be added only for the AMEs approved to perform class 3 aero-medical examinations.