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Get Medical Examination Report
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How to fill out the Medical Examination Report online
The Medical Examination Report is an essential document for assessing the fitness of commercial drivers. This guide will provide clear and supportive instructions on how to fill out the form accurately and effectively online.
Follow the steps to complete the Medical Examination Report online.
- Click ‘Get Form’ button to obtain the Medical Examination Report and open it in the form editor.
- Begin by entering the driver's information in Section 1. Fill in the driver's name, social security number, birthdate, address, contact numbers, age, and select the certification type.
- In Section 2, document the health history by answering questions on previous illnesses or injuries from the last five years. Provide information on any ongoing medications, including over-the-counter medications.
- Certify the accuracy of the information provided in Section 2 with the driver's signature and the date completed.
- In Sections 3 to 7, where medical examiners complete their assessments, make sure that visual and hearing tests, as well as vital statistics, are recorded accurately by the medical examiner.
- Ensure numerical readings for blood pressure, pulse rate, and other medical findings are documented as required.
- Finally, the medical examiner signs off on the report, confirming that the examination meets the necessary standards and includes relevant certification information.
- Once you've completed the examination report, save your changes and choose to download, print, or share the form as needed.
Complete your Medical Examination Report online today to ensure compliance and safety.
The Medical Examination Report Form, MCSA-5875, which is the long medical exam form that the driver and examiner complete during the course of the exam. The Medical Examiner's Certificate, MCSA-5876, also known as the wallet card or fed med card provided to drivers who are medically certified.