Get the free D.O.T. MEDICAL EXAMINATION REPORT - azdot

Page 1. To access the Medical Examination Report (MER) Form please click link below: CSA 5875.

How to fill out dot medical examination report

How to fill out DOT medical examination report:

1. Start by obtaining the appropriate form: The DOT medical examination report is also known as the FMCSA Physical Examination Report Form. This form can be downloaded from the Federal Motor Carrier Safety Administration (FMCSA) website or obtained from your employer.
2. Provide personal information: Begin by filling out your personal details such as name, address, date of birth, and contact information. Make sure to provide accurate and up-to-date information.
3. Answer the medical history questions: The next section of the form will require you to answer several questions related to your medical history. Be honest and thorough while providing information about any previous and existing medical conditions, surgeries, medications taken, and any disabilities or impairments that may affect your ability to operate a commercial vehicle.
4. Complete the physical examination section: This part of the form requires a thorough physical examination by a certified medical examiner. The examiner will check your vital signs, vision, hearing, and evaluate various body systems. Based on the examination, the examiner will assess your fitness for the job.
5. Discuss medications and medical conditions: If you suffer from any medical conditions or take medications, make sure to discuss them with the medical examiner. Certain medical conditions or medications may require additional documentation or evaluation to determine your eligibility for driving a commercial vehicle.
6. Certify and sign the form: Once all the sections have been completed and reviewed, sign and date the form. By signing, you certify that all the information provided is accurate and complete to the best of your knowledge.

Who needs DOT medical examination report:

1. Commercial Drivers: The DOT medical examination report is required for all commercial drivers who operate vehicles that fall under the jurisdiction of the Federal Motor Carrier Safety Administration (FMCSA). This includes drivers of commercial motor vehicles (CMVs) such as trucks, buses, and vehicles transporting hazardous materials.
2. Certified Medical Examiners: In addition to commercial drivers, certified medical examiners also need to be familiar with the DOT medical examination report. They are responsible for conducting the physical examination and completing the necessary sections of the form.
3. Employers and Regulatory Authorities: Employers of commercial drivers and regulatory authorities, such as the FMCSA, require and utilize the DOT medical examination report to ensure the physical fitness and safety of drivers on the road. This report helps determine if a driver meets the medical standards necessary for operating a commercial vehicle.

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