Some important tips on the MedXpress procedure.
After you complete the form, there is a procedure to "digitally sign" the document. Once that's done, you are shown the completed form with a confirmation number printed at the bottom. Do not click the proceed button as this will submit the file and you cannot retrieve it.
Save this page as a PDF file to your hard drive. Having this will make future submissions much easier.
Print this page.
Now you can press the button that allows you to proceed and submit the form.
Using scissors, cut off the confirmation number at bottom. When you go to the AME's office, DO NOT HAND OVER THIS CONFIRMATION NUMBER TO STAFF OR THE AME. Doing so will permit them to "open" the file and make the exam "live". A "live exam" can only end in three results: Approval, Denial, or Deferral.
With the exam not being live, then it is a "consultative" visit. Meaning that if something is found that stops you cold, or causes a looong delay, you have not caused any problems for yourself with a denial or deferral.
Approval while in the office is what you desire. So if the AME will conduct the exam without the confirmation number (some won't, most will) and then says, "Congratulations, you pass, I can approve you", then and only then, hand over the confirmation number.
Deferral means that a condition exists that prohibits the AME from approving you in the office and the medical certification standards require him to submit your file to the AMCD offices in Oklahoma City for the approval. If this was a known condition, and you had already gathered the required information, then this is just part of the process. But worse, and this happens to too many, the airman has bombed into the office not knowing the standards and must be deferred. Now a short time clock is running to chase around to your doctors to get documentation, tests, test results, and more. And a deferral does not always mean you will be approved, there is still a chance at being denied.
Denial of the certificate means that some condition exists that prevents you from ever obtaining a medical certificate . And if you are denied, you are denied from flying just about all powered aircraft, forever. You do not want to be denied.
As a consultative exam (aka you kept the confirmation in your pocket), if deferral or denial occurs, then you you have not jeopardized your future flying privileges and have the opportunity to discuss with the AME what steps can be taken to get to approval. And now you have the time and opportunity to execute these steps without being under time pressure of deferral, or the jeopardy of denial.
The final biggest bit of advice for the medical certificate:
Do not go into the AME's office until you know, with 100% confidence, that you will pass the exam.
If you have any specific medical questions, feel free to start a new thread under the Medical topics area and we will do our best to help.