Updated September 2026 to reflect current FAA guidance on FAA Form 8500-8 and MedXPress.
Every FAA medical exam starts with FAA Form 8500-8, which you fill out online in FAA MedXPress. It covers Items 1 through 20: your identity, the class of certificate you want, your medications, your medical history, recent visits to health professionals, and a certifying declaration. It looks simple, but mistakes on it are one of the most common reasons an exam turns into a deferral. Some mistakes can even lead to enforcement action. Here are six to avoid.
Mistake #1: Listing Only Your Prescriptions
Item 17a asks, "Do you currently use any medication (prescription or nonprescription)?" Many pilots list only what a doctor prescribed and skip what they buy off the shelf. The question covers both. Include over-the-counter pain relievers, allergy pills, sleep aids, and anything else you currently use. The FAA's instructions also ask you to note whether each medication was listed on a previous FAA medical application. The form doesn't name supplements, but listing them costs you nothing, and your AME can tell you whether they matter.
Over-the-counter drugs matter because some come with no-fly periods. The FAA classifies diphenhydramine (Benadryl) and doxylamine (Unisom SleepTabs, NyQuil) as sedating antihistamines. You may use them only occasionally, and you must not fly for 60 hours after each dose. Before you start the form, go through your medicine cabinet and write down every medication, the dose, and how often you take it.
Item 17b is a separate question: do you ever use near vision contact lenses while flying? If you use one contact lens for near vision and the other for distance (monovision), that is not allowed for flying. Contact lenses in both eyes for distance, and binocular bifocal or multifocal contact lenses, are acceptable.
Mistake #2: Leaving Out History, or Dropping a "Yes" You Gave Before
Item 18 lists 25 questions, 18a through 18y, from frequent headaches to mental disorders to admission to a hospital. Read each one exactly as worded, because some carry their own time window. Item 18n, for example, asks about substance dependence, a failed drug test ever, or substance abuse or use of an illegal substance in the last 2 years. Pilots most often get into trouble by leaving out old or "resolved" conditions, such as a course of antidepressants years ago. Disclose it and give context. A well-documented history of a resolved condition often doesn't stand in the way of certification.
Two rules trip up returning applicants. First, once you have answered yes to an Item 18 question, especially 18n (substances), 18o (alcohol), or 18v (arrests, convictions, and administrative actions), the FAA says you must always answer yes to it on future applications, even after the FAA has reviewed it and cleared you. Second, if nothing has changed about something you already reported, you can write PREVIOUSLY REPORTED, NO CHANGE in the explanation. You don't need to retell the whole story. Your AME still comments on it.
Don't count on an omission going unnoticed. By signing Item 20, you authorize the National Driver Register to release your adverse driving history to the FAA, and the FAA uses it to check your answers. If you report disability benefits under Item 18y, which covers any benefits regardless of source or amount, the FAA may verify them with other federal agencies such as the Social Security Administration and Veterans Affairs.
The stakes are real. An intentionally false statement on the application can be a federal crime under 18 U.S.C. 1001. Separately, the FAA can act against your certificates. Since November 3, 2025, the FAA's falsification rule has been 14 CFR 3.403, which replaced the old 14 CFR 67.403. Incorrect statements and omissions can also be grounds for action under 14 CFR 3.405. In medical falsification cases, the FAA's enforcement policy involves revoking all of your airman and medical certificates.
Mistake #3: Mishandling a DUI or Other Arrest
Item 18v asks about your history of arrests, convictions, and administrative actions. Alcohol- or drug-related driving incidents go here. The FAA says every incident must be reported, even a single DWI arrest, and even if you reported it on a previous application. Other convictions not related to traffic, such as assault or public intoxication, go under Item 18w, with the charge and the date.
Answering yes on MedXPress is not the only report you owe. Under 14 CFR 61.15(e), you must send a separate written notification to the FAA's Security and Hazardous Materials Safety Office within 60 calendar days of any alcohol- or drug-related motor vehicle action. That includes a conviction, or a license suspension, revocation, cancellation, or denial, including a suspension for refusing a breath or blood test. An arrest alone doesn't need a security report, but it must go on your next 8500-8. Missing the 60-day deadline can lead to denial of an application for up to a year, or to suspension or revocation of your certificates.
Mistake #4: Choosing a Medical Class Without Thinking It Through
Items 1 and 2 ask which class of medical certificate you're applying for. Your AME applies the standards for the class you request, not the flying you actually do. The FAA lets you apply for a higher class than you need. A student pilot might ask for a first-class exam to see whether they qualify for an airline career. Just know what comes with it. For example, a first-class applicant needs an electrocardiogram (ECG) at the first application after turning 35, then every year after turning 40.
Pick the class that matches what you plan to do. A private or student pilot generally needs a third-class certificate. A commercial pilot flying for compensation generally needs second-class. Exercising airline transport pilot privileges requires first-class.
Mistake #5: Showing Up Without Your Confirmation Number or Your Records
When you submit your application in MedXPress, you get a confirmation number. Your AME can't open your application without it, so bring it to your exam along with a government-issued photo ID. Plan your timing: your exam must happen within 60 days of submitting, or the application is deleted. An application you start but don't submit within 30 days is also removed.
Records matter just as much. For any yes answer on Item 18, look up the condition in the FAA's Guide for Aviation Medical Examiners and bring what its Evaluation Data column asks for. That is often a current progress note from your treating doctor covering the history of the condition, current medications and side effects, test results, and prognosis. For some conditions, the AME can issue your certificate the same day if the right documents are in hand. Without them, your application may be deferred to the FAA for review, which can add weeks or months.
Item 19 is closely related. List every visit in the last 3 years to a physician, physician assistant, nurse practitioner, psychologist, clinical social worker, or substance abuse specialist, with the name, date, address, type of provider, and reason. You can combine repeat visits for the same condition on one line. You can leave out routine dental, eye, and FAA medical exams, as well as employee assistance program visits, unless those visits were for substance abuse or led to a referral for psychiatric evaluation or treatment. List counseling only if it was for a substance abuse or psychiatric condition.
Mistake #6: Rushing Through and Submitting
Here's what surprises many pilots: you don't sign the application at your appointment. Before MedXPress will submit it, you certify the declaration in Item 20 electronically, confirming your answers are complete and true. Once you've certified and submitted, you can't change the application yourself. If something needs correcting, your AME will discuss it with you and make the change in the FAA's system with your approval.
Common rush errors include a mistyped certificate number or date of birth, a misspelled medication, a skipped Item 19 visit, and a forgotten hospital admission (Item 18u). The Social Security number is optional. If you'd rather not give it, choose the International/Declined to Submit option. Fill out the form somewhere quiet with your records in front of you. Open the help rows marked "+" or the 8500-8 Instructions link whenever a question isn't clear. Review every answer before you certify and submit.
Form 8500-8 isn't a trap, but it does demand accuracy and completeness. Disclose everything, keep your answers consistent from one application to the next, bring your confirmation number and records, and your exam has the best chance of ending with a certificate in hand.