Get Ny Ds-874 2015

The NY DS-874 is a medical examination report specifically for drivers under Article 19-A. This guide provides a step-by-step approach to assist users in completing the form accurately online, ensuring a smoother filing process.

Follow the steps to accurately complete the NY DS-874 online.

1. Click ‘Get Form’ button to obtain the form and open it in your preferred editor.
2. Complete the driver/carrier information section. This includes entering the driver's first and last names, middle initial, date of birth, address, client/license ID number, and carrier name. Ensure all fields are filled out accurately.
3. In the health history section, review each item carefully. Answer 'Yes' or 'No' to the health inquiries, indicating any relevant medical conditions. If any 'Yes' answers are provided, detail the condition, onset date, and treatment information in the space provided.
4. List all medications currently being taken, including over-the-counter drugs. If necessary, use the additional DS-874C form for further comments on medications.
5. The medical examiner will complete the testing sections (vision, blood pressure, hearing, and any additional findings). Ensure that these fields are filled out accurately during the examination.
6. In the medical examiner's certification section, the examiner will indicate whether the driver is qualified or not qualified to operate a bus and will provide any necessary restrictions.
7. Review all entries for accuracy and completeness. Once confirmed, the driver and the medical examiner will sign where indicated.
8. Finally, save your changes. You can download, print, or share the completed form as necessary, ensuring that the original remains in the employee's 19-A file.

Complete the NY DS-874 online efficiently and accurately!