Get Faa Form 8500 14

Filling out the Faa Form 8500 14 is a critical step for applicants undergoing an ophthalmological evaluation for glaucoma. This guide will provide you with a comprehensive overview and step-by-step instructions to help you complete the form online efficiently and accurately.

Follow the steps to complete your Faa Form 8500 14 online.

1. Click ‘Get Form’ button to obtain the form and open it in your editor.
2. In section 1, enter the date of completion. This should be the date you are filling out the form.
3. In section 2A, provide your full name — last name, first name, and middle name.
4. In section 2B, fill in your date of birth using the format month, day, year.
5. In section 2C, indicate your sex by selecting either 'M' for male or 'F' for female.
6. In section 3, input your complete address, including street number, city, state, and zip code.
7. In section 4, document your medical history related to health and vision problems, both past and present.
8. In section 5, state any family history of glaucoma.
9. Section 6 requires a diagnosis of your condition. Indicate the type of glaucoma and how it was discovered and confirmed.
10. In section 7, if surgery has been performed, specify the type and which eye was affected. Also, indicate if surgery is anticipated within 24 months.
11. Section 8 asks for your initial response to therapy; provide the necessary details on medication used.
12. In section 9, specify the present treatment including the name, strength, and frequency of medications.
13. Section 10 requires you to describe the adequacy of control over your condition, including any test results.
14. Section 11 is for recording field of vision results from tests conducted.
15. Section 12 involves documenting visual acuity results, both corrected and uncorrected.
16. In section 13, indicate whether you wear glasses or contact lenses and provide specific details.
17. Section 14 requires a statement on the size and reaction of your pupils.
18. In section 15, describe any abnormalities noted during your ophthalmoscopic examination.
19. In section 16, record findings from the slit lamp examination of each eye.
20. Section 17 estimates your fusion ability and methods used in the examination.
21. Finally, sections 18A and 18B require the typed name and signature of your eye specialist.
22. Once all sections are complete, remember to save your changes, then download, print, or share your completed form as needed.

Begin your journey by completing your Faa Form 8500 14 online now.