Free Printable Dot Physical Forms The Federal Motor Carrier Safety Administration requires that interstate commercial motor vehicle drivers maintain a current Medical Examiner s Certificate MEC Form MCSA 5876 to drive
SECTION 1 Driver Information to be filled out by the driver Has your USDOT FMCSA medical certificate ever been denied or issued for less than 2 years Yes No Not Sure CLP CDL Applicant Holder See instructions for definitions 2024 Medical Certification Forms MCSA 5875 MCSA 5876 New expiration date on the forms is 03 31 2025 PDF Versions of the forms are available at these links on the FMCSA website Medical Examination Report MER Form MCSA 5875 Medical Examiner s Certificate MEC Form MCSA 5876
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DOT Physical Forms CDL Medical Examination Report MER Form MCSA 5875 PDF 456 KB This form is an example of what patients can expect The MER will be completed online at the center and does not need to be printed and completed beforehand SECTION 1 Driver Information Driver ID Veried By Has your USDOT FMCSA medical certicate ever been denied or issued for less than 2 years Yes No Not Sure CLP CDL Applicant Holder See instructions for denitions
Get the Newest DOT Physical Forms The expiration date on the Medical Examination Report Form MCSA 5875 Medical Examiner s Certificate MCSA 5876 and Insulin Treated Diabetes Mellitus Assessment Form MCSA 5870 has been updated to 12 31 2024 and all forms are posted below To record results of a driver s physical examination to determine qualification to operate a commercial motor vehicle CMV and to promote driver health in interstate commerce according to the requirements in 49 CFR 391 41 49 Providing this information is mandatory
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DOT Physical Form Medical Card Certificate Forms MCSA 5875 MCSA 5876 in PDF Free to Print or Download Includes Instructions to Physician and Commercial Drivers Minimum Requirements for a CDL License Review and discuss pertinent driver answers and any available medical records Comment on the driver s responses to the health history questions that may affect the driver s safe operation of a commercial motor vehicle CMV TESTING
Easily find and download DOT physical forms or other DOT examination paperwork as needed Download and print FMCSA medical forms and CMV driver medical clearance forms necessary for DOT CDL certification Get back on the road faster by filling your forms out ahead of time
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https://www.fmcsa.dot.gov/regulations/medical/...
The Federal Motor Carrier Safety Administration requires that interstate commercial motor vehicle drivers maintain a current Medical Examiner s Certificate MEC Form MCSA 5876 to drive
https://www.fmcsa.dot.gov/sites/fmcsa.dot.gov/files...
SECTION 1 Driver Information to be filled out by the driver Has your USDOT FMCSA medical certificate ever been denied or issued for less than 2 years Yes No Not Sure CLP CDL Applicant Holder See instructions for definitions
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Free Printable Dot Physical Forms - 1 DRIVER INFORMATION Driver completes this section PRINT IN CAPITAL LETTERS USING BLACK OR DARK BLUE INK PLEASE READ THE INSTRUCTIONS TO THE DRIVER BEFORE ANSWERING
