Insulin-treated pilots applying under the FAA's diabetes protocol need an initial comprehensive evaluation from their treating board-certified endocrinologist within the past 90 days. This two-page specification lists every item the report must detail and comment on: diabetes history, medication and monitoring, psychosocial screening, glucose control, a narrated physical exam, assessment and plan, and the next follow-up date.
The treating board-certified endocrinologist writes the report, addressing every listed item. It is a narrative report from the evaluation, not a fill-in form.
Download the current version from the source each time; forms change without notice.
Diabetes Mellitus Type I or Type II Insulin Treated Initial Comprehensive Report
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.
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.
The pilot's treating board-certified endocrinologist, from an evaluation within the past 90 days. The report must detail and comment on every item in the FAA specification, which is modified from the American Diabetes Association Standards of Medical Care 2020.
Screening for depression, anxiety and disordered eating, for example with the PHQ-9 or PHQ-2, a cognitive impairment assessment with formal testing if clinically indicated, and a review of diabetes self-management education, including dietician or educator visits and barriers to self-management.