FMCSA Medical Exam Forms

All drivers are responsible for filling out specific sections of the FMCSA Medical Examination Report Form.  This form can be printed and filled out ahead of the office visit, expediting the examination.  

FMCSA Medical Examination Report Form

Medical Clearance Forms

For use by treating medical providers to supply additional information related to a patient's medical conditions.  This information is necessary to complete DOT medical examinations for drivers with certain medical conditions.  Use the "Medical Clearance Form" for any medical condition not listed below.

Non-Insulin-Treated Diabetes

DOT Clearance Form 

Insulin-Treated Diabetes

DOT Clearance Form

Hypertension

DOT Clearance Form

Cardiac

DOT Clearance Form

Obstructive Sleep Apnea

DOT Clearance Form

Medical

DOT Clearance Form

Return to Duty / Work

DOT Clearance Form

Special Medication

DOT Clearance Form

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