FAA / HIMS-Certified Psychiatric Evaluation 

Pilot or AME Call: 918 332 9809 (Leave Message, and Dr. Migdalski will call you back directly) AND/OR: Send secure Spruce message (https://spruce.care/avenuespsychiatry)anytime, (including if possible): • FAA letter & best times to reach by phone • AME/HIMS-AME name, email, phone • We hold a brief call to outline scope, fees, and required records -> Reserve Saturday Appointment in Tulsa, Oklahoma. • Appointments are usually scheduled within weeks, not months after initial contact • For Aviators traveling in -> We’ll do our best to schedule your visit for same-day fly-in/fly-out.

These are the documents commonly required for a HIMS Psychiatry Evaluation. Each Aviator's situation will be different, and documents & consents required will be discussed as per each situation. • FAA Letter • FAA Form 8065-2 (airman records request) • Prior psych/substance treatment records (in-pt & out-pt) • Therapy progress notes • Arrest/conviction reports (e.g., DUI police & court docs) • Drug/alcohol test results & rehab discharge summaries • Neuropsych & CogScreen-AE scores • Medication list & PCP records • Consent & HIPAA signed ROI allowing release to FAA and AME • Collateral Interviews Interviewing employer or spouse Dr. Migdalski personally values the intersection of direct access & leveraging HIPAA compliant technologies to minimize the administrative burdens. Throughout the process Spruce will enable: Direct secure messaging, Record submission, Scheduling, and Review/Signing of consent forms in one place. Its Free for you!

• Face-to-face HIMS psychiatric exam (2-3 hrs). • Standardized assessments • Collateral interview(s): spouse/peer/flight-dept • Collect final consents for records release to FAA & AME.

• Speak with referring AME/HIMS-AME • Request any remaining documents & speak with collateral sources • Draft comprehensive FAA-format report • Submit to AME & FAA Aeromedical Certification Division (or as indicated on initial letter)

• Rate: $340 per hour • Initial charge: $1,500, due at the start of the in-person evaluation. No deposit is required. Initial care coordination (consents, scheduling, initial call) is not billed. • Good Faith / Flexibility: An aviator may withdraw at any time before the initial in-person evaluation without cost. However, if repeated cancellations or poor communication become an issue, Dr. Migdalski may choose not to move forward so that appointment availability can be preserved for other aviators. • Final charge: Remaining balance after report is finalized & feedback session. Final report sent at time of final payment. • Total Time: Often in the range of 9-12 hours, but case specifics are highly unique (can be discussed at time of initial call). We accept credit cards (Visa, MasterCard, AmEx, Discover) through an encrypted link or by tap. Checks are accepted on a case by case basis for HIMS evaluations. A secure link for online payments can also be provided. ACH, mobile payments, apple pay and insurance are not accepted.

Substance-Use / Alcohol (Traditional HIMS) Treatment First → Evaluation Second: As soon as residential/IOP treatment is complete and records are ready HIMS Psychiatry Evaluation may begin. • FAA & Part 121 carriers usually expect 28 day minimum residential rehab • Post-treatment HIMS monitoring: professional after-care, daily/weekly 12-Step or equivalent, and monthly sobriety testing. • One year follow up evaluation SSRI / Antidepressant Pathway • Applies only to FAA-approved meds (Celexa, Lexapro, Prozac, Zoloft, Pristiq, Cymbalta, plus Wellbutrin XR (NOT IR), Effexor, Viibryd). • Often longer than a “straightforward HIMS” alcohol case even when compliant -> 6 months medication & symptom stability. • “FAA-approved” ≠ automatic clearance. The eight antidepressants on the FAA’s “conditionally acceptable” list are simply the only medications the FAA will consider for certification—they do not bypass the Antidepressant Special-Issuance Pathway. In short, “approved” means eligible for review—not “pre-cleared.” Other Mental-Health Conditions (e.g., PTSD, ADHD, Bipolar) • Same evaluation framework. The FAA makes the regulatory determination, not the psychiatrist. • Focus is on diagnosis clarity, stability, and regulatory (not DSM-5) standards. • Documentation gaps (hospitalizations, therapy notes) are the usual slowdown.