Get Faa Gender Dysphoria Mental Health Status Report 2019-2025

The FAA Gender Dysphoria Mental Health Status Report is an essential document for individuals seeking to address their mental health status in relation to gender dysphoria. This guide will walk you through each section of the form to ensure its accurate and complete submission.

Follow the steps to successfully complete the FAA Gender Dysphoria Mental Health Status Report online.

1. Use the ‘Get Form’ button to access the FAA Gender Dysphoria Mental Health Status Report and open it in your preferred online editor.
2. Begin by entering your name in the designated field. Ensure that you enter your full legal name as it appears on official documents.
3. Fill in your birthdate in the appropriate format, ensuring accuracy to avoid any discrepancies in your application.
4. Enter your Applicant ID number in the specified field. If you do not have this number, follow the guidelines provided for obtaining it.
5. In the PI# field, provide your personal identification number as listed on previous documentation or identification.
6. Follow the instructions provided for the treating provider's evaluation section. This part must be completed by a qualified mental health professional.
7. Indicate whether the treating provider meets the criteria of a qualified mental health professional, as defined by WPATH guidelines, by checking the appropriate box.
8. In the next section, confirm if the airman meets the DSM-5 diagnostic criteria for gender dysphoria. Check either 'Yes' or 'No' and provide explanations as necessary.
9. Complete the psychiatric history section by providing any current or previous mental health diagnoses and indicating if there has ever been any psychiatric hospitalization or suicide attempts.
10. Detail any current or previous psychiatric treatments, including dates, medication names, dosages, and any side effects or concerns.
11. In the current status section, articulate the airman’s mental health status, ensuring to note if psychotherapy is exclusively for gender dysphoria.
12. Indicate if there are any concerns regarding cognitive dysfunction or the need for a neuropsychological evaluation, providing explanations as required.
13. Finally, the treating provider must sign and date the form, including their name or office stamp and phone number for verification.
14. Once all sections are accurately filled out, you can save the changes, and choose to download, print, or share the completed form as needed.

Complete your FAA Gender Dysphoria Mental Health Status Report online today for a seamless submission process.