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FAA CACI Testicular Cancer Worksheet

Pilots with a history of testicular cancer can be certified in the AME's office through this Conditions AMEs Can Issue (CACI) checklist. The AME reviews the treating urologist's or oncologist's progress note from a visit within 90 days of the exam and confirms the cancer is stable with no spread or recurrence, has never metastasized, active treatment is complete, and the pilot has no symptoms.

Who completes it

The AME completes the checklist and marks the Block 60 outcome. The treating urologist, oncologist or other specialist writes the current, detailed Clinical Progress Note the AME reviews.

Submitting and payment

How to submit it
A qualifying case is noted as 'CACI qualified testicular cancer' in Block 60 of FAA Form 8500-8, and the documents do not need to be submitted. Otherwise the AME defers and submits the supporting documents.

Good to know

  • Accepted current treatment is none, surveillance or watchful waiting. If the pilot is on chemotherapy or radiation, the AME defers the exam.
  • The note must confirm no spread or recurrence, no current or past metastatic disease, and that active treatment is complete with no new treatment recommended.
  • After surgery, the note must confirm the pilot is off pain medication, fully recovered and released by the surgeon.
  • If 5 or more years have passed since any treatment, with no metastasis or recurrence, the CACI is not required; the AME notes this in Block 60.

Get the official form

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

CACI – Testicular 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.

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Frequently asked questions

Does the testicular cancer CACI allow surveillance?

Yes. Current treatment may be none, surveillance or watchful waiting. The treating physician's note must also confirm the cancer is stable without spread or recurrence, there is no current or historic metastatic disease, and any surgery has been followed by full recovery and release by the surgeon.

What happens if a pilot is still on chemotherapy for testicular cancer?

The worksheet tells the AME to defer the exam while the pilot is on chemotherapy or radiation, following the disposition table. The supporting documents then go to the FAA for review instead of the AME issuing in the office.