Pilot & Air Traffic Controller Evaluations for the Federal Aviation Administration (FAA)
(COGSCREEN, SSRI, TBI, Stroke/CVA, ADD/ADHD, HIV+, Sleep Apnea, Substance Abuse, Alcohol Abuse, Anxiety, etc.)
Please download and complete the following forms and bring to your appointment:
Child Evaluation Forms (Ages 4-18 years)
Please download, complete, and bring to your appointment.
1. Consent for Services
2. Payment Policy
3. History: Medical, Social, Behavioral, Emotional
4. Academic Problems Parent-Student Form
Adult Evaluations (Ages 19-59 years)
Please download and complete the following forms and bring them to your appointment:
1. Consent for Services
2. Payment Policy
3. Background Information
Geriatric Evaluations (Ages 60+ years)
Please download and complete the following forms and bring them to your appointment:
1. Consent for Services
2. Payment Policy
3. Background information
4. Release of Information
*Please see HHS.gov for detailed information regarding your privacy rights.