JAR FCL Med Cert Class 2

Statens Luftfartsvæsen

Civil Administration – Denmark

HELBREDSGODKENDELSE KLASSE 2

MEDICAL CERTIFICATE CLASS 2

ISSUED IN ACCORDANCE WITH ICAO

STANDARDS AND JAR-FCL 3

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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 the need for regular use or correcting lenses

I / Udstedelsesland/State of Licence Issue
Danmark/Denmark
III / Referencenummer/Reference No
(first letters): Country Code
IV / Indehaverens efter- og fornavn/
Last and first name(s) of holder
V / Adresse/Address
XIV / Fødselsdato/ Date of Birth:
VI / Nationalitet/ Nationality:
VII / Indehaverens underskrift/
Signature of holder:

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 or the AMS, who shall subsequently inform the Authority in writing of such injury or pregnancy, and as soon as the period of 21days has elapsed in the case of illness. The medical certificate shall be deemed to be suspended upon the occurrence of such in jury or the elapse of such period of illness or the confirmation of the pregnancy

II / Helbredsgodkendelse klasse 2/
Medical Certificate Class 2
IX / Udløbsdato/Expiry date of this certificate:
XIII / Begrænsninger/Limitations
X / Dato og udsteders underskrift/
Date of issue and signature of issuing officer:
XI / Stempel/Stamp:
MEDICAL CERTIFICATION
Licence / Class 2
Validity of Medical Certificate
(Max 45 days before revalidation) / Under age 40: 60 months
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 / For instrument Rating only:
Under age40 5 yearly
Age 40 and over 2 yearly
Ophthalmology Examination / At initial by AME or specialist
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
Undersøgelsesdato/
Examination date:
Udløbsdato for seneste helbredsgodkendelse/
Expiry date of previous Medical Certificate:
Vejledende information/
Advisory Information: / Sidste
Most recent / Næste/
Next:
Elektrocardiogram/
Elektrocardiogram
Audiogram/
Audiogram:
Bemærkninger/Comments:
Code / Limitation, Condition, Variation
TML / Valid only for …. Months
VDL / Shall wear corrective lenses and carry a spare set of spectacles
VML / Shall wear multifocal lenses and carry a spare set of spectacles
VNL / Shall have available corrective spectacles for near vision and carry a spare set of spectacles
VCL / Valid by day only
OML / Valid only as or with qualified co-pilot
OFL / Class 1 valid for flight engineer duties only
OCL / Valid only as co-pilot
OSL / Valid only with safety pilot and I aircraft with dual controls
OAL / Restricted to demonstrated aircraft type
OPL / Valid only without passengers
APL / Valid only with approved prosthesis
AHL / Valid only with approved hand controls
AGL / Valid only with approved eye protection
SSL / Special restrictions as specified
SIC / Special instructions – Contact AMS
AMS / Recertification ir renewal only by AMS
REV / Medical Certificate issued after review procedure. Special instructions may apply. AMS may be contacted
RXO / Requires specialist ophthalmological examinations