Additional fees may apply to those pilots with complicated medical histories and those who require additional paperwork and/or mailing related to special issuance or other medical conditions for which the FAA requires a status report and/or test results from the pilot's treating physician.  Missed appointments without advance notification are subject to an additional fee of $75. Payment is expected at the time of service. There is an additional fee of $10 if payment is not made at the time of service.  Acceptable methods of payment include personal checks, business checks, credit card and cash. A receipt can be provided at the time of service.