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Individual Inquiry Confidential Questionnaire



NATCA Member Confidential Questionnaire



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Consult a VFS Doctor

NATCA Member Confidential Questionnaire

Thank you for choosing Virtual Flight Surgeons!  The VFS team is proud to be the aeromedical service provider for the NATCA controllers.  To assist you in determining how to report medical conditions & for guidance to your treating provider for clinical documentation of your condition, please see the following articles:

Current HR guidance requires reporting of all prescription AND over the counter medications to supervisors before return to safety sensitive duty.  The following guidelines may assist controllers and their supervisors in determining if a medication is allowed, but remember that even if a medication is typically allowed, the underlying condition may be disqualifying: 

This Confidential Questionnaire is provided for NATCA members in good standing who wish to submit a question.  This service is provided as a no-cost member benefit.  Once submitted, a physician will respond within 2 business days.  For reference, controllers may want to review our Air Traffic Control and Security page or review the following links to ATCS medical standards:

  • Medical Standards for ATC 3930 3a - If large file doesn't load, try parts 1-3
  • 3930 3a Part 1
  • 3930 3a Part 2
  • 3930 3a Part 3
  • 3930 3a Part 4
  • Medical Standards for Terminal and En Route Centers for ATC Positions FAA Brochure
  • Order JO 7210.3V Facility Operation & Administration, Feb 14, 2008 - Medical Chapt 8
  • Human Resource Policy Manual (HRPM), Standards of Conduct

  • HRPM Human Resources Operating Instructions for Drugs & Alcohol - Jul 08
  • Drug and Alcohol Free Workplace, DOT Order 3910.1c Apr 2006
  • DOT Guide - What Employees Need to Know About DOT Drug & Alcohol Testing
  • DOL Family Medical Leave Act
  • DOL FMLA Leave Benefits
  • NATCA/FAA Contract "Imposed Work Rules" - June 2006 - Note these have been superceded by new contract
  • If you have lost or forgotten your membership number, please contact NATCA membership services at 1-800-266-0895.

     

    **PLEASE NOTE**  The field below requesting information on your present "Class FAA Medical Certification" only needs to be completed if you also hold a pilot's medical certificate in addition to ATC medical certification.


    Name


    NATCA Member ID


    Address 1


    Address 2


    City


    State


    Postal/Zip Code


    Country


    Home Phone


    Work Phone


    Cell Phone


    Fax


    E-Mail


    Confirm E-Mail


    Date Of Birth

    Class FAA Medical Certification
     First   Second   Third


    Heard about VFS


    If other, please specify

    Preferred Contact Method
     Home   Work   Cell   Email

    DO NOT Contact by
     Home   Work   Cell   Email


    Best time to contact


    Date of Last FAA Medical Exam


    Aviation Medical Examiner Name

    ATCS Duties
      ATCT  ARTCC  TRACON  Admin


    Duty Location


    FAA Region


    Are you currently performing unrestricted duties?


    Are you requesting grievance/legal representation?


    Do you give consent to discuss details of this case with NATCA representatives?


    Who do you authorize VFS to contact?


    Question