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FAA CACI Essential Tremor Worksheet for AMEs

Pilots with essential tremor that is stable and not disabling can be certified at the AME's office under the FAA's CACI program. This worksheet, updated 07/26/2023, requires the treating physician or neurologist to confirm the diagnosis and stability, no tremor that limits daily tasks, and no treatment other than a beta blocker, with no reliance on the medication to function.

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 neurologist no more than 90 days before the AME exam. The AME also reviews any supporting documents.

Submitting and payment

How to submit it
If all criteria are met, the AME issues, notes 'CACI qualified Essential Tremor' 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

  • Disabling tremor includes trouble holding a cup, handwriting or flipping switches on aircraft; any such limitation takes the pilot outside the CACI.
  • A beta blocker such as propranolol or metoprolol is the only CACI-eligible medication, and the pilot must not have a disabling tremor when it is missed or wears off.
  • Gabapentin, primidone and other potentially sedating drugs are not acceptable; weighted gloves, special utensils and deep brain stimulation also do not CACI qualify.
  • The tremor disposition table and the FAA's neurologic evaluation specifications cover cases that fall outside the CACI.

Get the official form

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

CACI – Essential Tremor 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.

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Frequently asked questions

Can a pilot taking propranolol for tremor get an FAA medical?

Under the CACI, a beta blocker such as propranolol or metoprolol is the only eligible medication for essential tremor. The pilot must not depend on it to function, meaning no disabling tremor when a dose is missed or wears off, and the treating physician's note should address that directly.

Is primidone acceptable for the FAA essential tremor CACI?

No. The worksheet states that gabapentin, primidone and other potentially sedating medications are not acceptable for aeromedical purposes, so the AME must not issue under the CACI. The tremor disposition table describes possible Special Issuance options for those pilots.