Under the Aeronautics Act, physicians and optometrists in Canada must report a patient they believe is a pilot, flight engineer, air traffic controller or other holder of an aviation document with medical standards, when they think the patient has a condition likely to be a hazard to aviation safety. This one-page form is how that report reaches Transport Canada's Civil Aviation Medicine branch.
Any physician or optometrist completes Sections 1 to 3, identifying the licence holder, themselves and the condition; being a CAME is not required. A Regional Aviation Medical Officer completes Section 4 when reviewing the report.
Download the current version from the source each time; forms change without notice.
Civil Aviation Medicine Medical Condition Reporting Form
Formulaire de déclaration de l'état de santé de la médecine aéronautique civile
Upload the fillable PDF once and Vero Documents fills it from the visit note and the chart, ready for you to review and sign. Download, print, or email the finished form, with the patient’s consent.
A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms change without notice, so download the current version from the official page before you fill it in.
Vero is not affiliated with, or endorsed by, the agencies and insurers listed here. Read our editorial policy.
Yes. The Aeronautics Act requires physicians and optometrists to report a patient they believe holds a Canadian aviation document with medical standards, such as a pilot, flight engineer or air traffic controller, when they think the patient has a condition likely to be a hazard to aviation safety. Form 26-0011 is the reporting route.
Transport Canada says the Aeronautics Act protects physicians and optometrists from legal or disciplinary proceedings for information shared in good faith, and that certificate holders are deemed to consent to the disclosure. The report goes to Civil Aviation Medicine, where a Regional Aviation Medical Officer reviews it.
No. Any physician or optometrist can complete it, whether or not they are a Civil Aviation Medical Examiner. The form asks whether you are a physician or an optometrist, your language of correspondence and contact details, your relation to the licence holder, and a description of the condition.