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FAA CACI Bladder Cancer Worksheet for AMEs

Pilots treated for bladder cancer can be certified at the AME's office under the FAA's CACI program when the treating physician's note verifies the cancer is stable, has never been muscle-invasive or metastatic, and active treatment is complete with nothing new recommended. This worksheet, updated 04/27/2022, also allows maintenance intravesical BCG or mitomycin.

Who completes it

The AME completes the worksheet from a current, detailed Clinical Progress Note written after a clinic visit with the treating physician or specialist, such as a urologist or oncologist, no more than 90 days before the AME exam.

Submitting and payment

How to submit it
If all criteria are met, the AME issues, notes 'CACI qualified bladder cancer' in Block 60 and keeps the documents on file without sending them to the FAA; otherwise the AME defers and submits them.
Who pays
The FAA does not set AME examination fees; the pilot pays the examiner, and the FAA recommends the usual and customary local fee for similar services.

Good to know

  • If the cancer recurred, the note must confirm no spread outside the bladder; after surgery, the pilot must be off pain medication, fully recovered and released by the surgeon.
  • Maintenance intravesical BCG or mitomycin is acceptable, but the pilot should not fly until 24 hours after treatment and free of symptoms.
  • If 5 or more years have passed since any treatment, with no metastatic disease or recurrence, CACI is not required; the AME notes this in Block 60.
  • A pilot currently on chemotherapy or radiation does not qualify, and the AME defers the exam as the disposition table directs.

Get the official form

Download the current version from the source each time; forms change without notice.

CACI – Bladder Cancer Worksheet

Official pagePDF

Fill it with Vero

If your copy of the form is a fillable PDF, upload it 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.

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How this list is checked

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 and their requirements change without notice, so check the official page for the current version before you complete one.

Vero is not affiliated with, or endorsed by, the agencies and insurers listed here. Read our editorial policy.

Frequently asked questions

What does the urologist need to document for the FAA bladder cancer CACI?

A current, detailed clinical progress note from a visit within 90 days of the AME exam verifying the cancer is stable, any recurrence stayed within the bladder, there was never muscle invasion or metastasis, active treatment is finished with no new treatment recommended, and the pilot has no symptoms.

Can a pilot fly while on BCG maintenance for bladder cancer?

Under the CACI, maintenance intravesical BCG or mitomycin is acceptable, but the worksheet says the pilot should not fly until 24 hours after each treatment and only when free of symptoms. A pilot on chemotherapy or radiation does not qualify, and the AME defers.