2023年12月20日 · 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. As part of the physical, drivers are required to fill out the medical history portion of the Medical Examination Report (MER) Form, MCSA-5875.

Medical Examiners should start using the forms with the 12/31/2024 date as soon as possible.

Medical Examination Report Form (for Commercial Driver Medical Certification) Last Name: Middle Initial: Street Address: Driver’s License Number: E-Mail (optional): CLP/CDL Applicant/Holder*: Has your USDOT/FMCSA medical certificate ever been denied or issued for less than 2 years? Have you ever had surgery? If “yes,” please list and ...

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.

2018年8月31日 · 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

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.

Form MCSA-5875 OMB No.: 2126-0006 Expiration Date: 03/31/2025 Medical Examination Report Form (for Commercial Driver Medical Certification) U.S. Department of Transportation Federal Motor Carrier Safety Administration Public Burden Statement A Federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a ...

2018年8月31日 · Medical examiners are required to complete the Medical Examination Report Form for every driver physical examination performed in accordance with 49 CFR 391.41.

2024年1月15日 · Medical examiners must provide a copy of a driver's medical exam certificate to a driver's prospective or current motor carrier employer. It is NOT mandatory, however, that medical examiners provide a copy of the long medical exam form.

Trucker Docs answers questions from commercial drivers about DOT physical requirements, FMCSA regulations, medical certificate, and DOT long form.