Get the free FMCSA Form MCSA-5876. Medical Examiner's Certificate

Form MCSA5876OMB No.: 21260006 Expiration Date: 11/30/2021Please note, the expiration date on this form relates to the process for renewing the Information Collection Request that includes this form

How to fill out fmcsa form mcsa-5876 medical

How to fill out fmcsa form mcsa-5876 medical

1. Begin by downloading the FMCSA form MCSA-5876 medical from the official FMCSA website.
2. Fill out the top section of the form, providing your personal information, such as your full name, address, and date of birth.
3. Proceed to section A of the form and answer the questions regarding your medical history, including any previous surgeries, illnesses, or conditions.
4. In section B, provide details about any medications you are currently taking and any allergies you may have.
5. If you have had any vision or hearing issues, indicate them in section C.
6. Section D is for documenting any cardiovascular or respiratory conditions you may have.
7. In section E, provide details about any psychiatric or psychological conditions.
8. Section F is for documenting any neurological or musculoskeletal conditions.
9. Answer the questions in section G regarding your alcohol and drug use.
10. In section H, provide information about any loss of consciousness, seizures, or other physical impairments.
11. If you have diabetes, you must complete section I and have your healthcare professional fill out the Medical Examiner's Certificate.
12. Review the completed form for completeness and accuracy before signing and dating it.
13. Make a copy of the form for your records and submit the original to the appropriate authority as required.
14. It is important to keep a copy of the Medical Examiner's Certificate with you while operating a commercial motor vehicle.

Who needs fmcsa form mcsa-5876 medical?

1. FMCSA form MCSA-5876 medical is required for individuals who are applying for or renewing their commercial driver's license (CDL). It is necessary for those who operate commercial motor vehicles in interstate commerce and fall under the FMCSA's jurisdiction.
2. This form is also required for individuals who wish to operate a commercial motor vehicle that requires a CDL and falls under the safety regulation of FMCSA, regardless of interstate or intrastate operation.

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What is fmcsa form mcsa-5876 medical?

FMCSA Form MCSA-5876 is a medical examination report for commercial motor vehicle drivers.

Who is required to file fmcsa form mcsa-5876 medical?

Commercial motor vehicle drivers are required to file FMCSA Form MCSA-5876 medical.

How to fill out fmcsa form mcsa-5876 medical?

FMCSA Form MCSA-5876 medical must be filled out by a qualified medical examiner after conducting a thorough medical examination of the driver.

What is the purpose of fmcsa form mcsa-5876 medical?

The purpose of FMCSA Form MCSA-5876 medical is to ensure that commercial motor vehicle drivers meet the medical standards necessary to safely operate a commercial motor vehicle.

What information must be reported on fmcsa form mcsa-5876 medical?

FMCSA Form MCSA-5876 medical must include the driver's personal information, medical history, results of the medical examination, and any recommendations or restrictions for driving.