Videos from the road including Big Rig Truck Accidents, Wrecks and Crashes, Trucker Training Videos, Real Life Video about the Perils of Speed Governors in Big Rig Trucks, Road Train Videos and Global Trucker Videos.
CDL Drivers DOT Medical Exam Form MCSA-5875 PDF
CDL Drivers Medical Minimum Requirements
Posted on 17th Dec 2021 @ 9:27 AM
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. Please note that the only change to the forms is the change in the OMB expiration date from 11/30/2021 to 12/31/2024.
Medical Examiners should start using the forms with the 12/31/2024 date as soon as possible. However, MEs that have purchased these forms in bulk, or require time to reprogram electronic system forms, may continue to use the old forms until stocks have been depleted or forms have been reprogrammed but should transition to use of the new forms as quickly as possible. Based on this guidance, SDLAs are encouraged to continue to accept these forms.
9 pages. Print in Portrait. Includes CDL Medical Card Certificate on Last page. Scroll down.
As a part of the medical certification process for insulin treated diabetes mellitus (ITDM) individuals, the Federal Motor Carrier Safety Administration (FMCSA) requires that the Insulin Treated Diabetes Mellitus Assessment Form (ITDM), MCSA-5870, be completed by the ITDM individual’s Treating Clinician attesting that the individual has a stable insulin regimen and properly controlled diabetes. ITDM individuals are required to provide the ITDM Assessment Form, MCSA-5870, to the Certified Medical Examiner within 45 days of completion by the Treating Clinician.
The 391.41 CMV Driver Medication Form - MCSA-5895 - Requests additional information from CDL drivers regarding medications prescribed by the their treating physician for Medical Examiners to use in determining if a driver is medically qualified under 49 CFR 391.41.