Get Ny Ds-874 2019-2026

The NY DS-874 is a crucial document used for the medical examination report of drivers under Article 19-A. This guide will provide you with clear, step-by-step instructions to help you fill out the form accurately and efficiently.

Follow the steps to complete the NY DS-874 form online

1. Click ‘Get Form’ button to access the NY DS-874 document and open it in your preferred online editor.
2. Begin by completing the driver/carrier information section. Enter the driver's first name, last name, middle initial, date of birth, city, street address, license ID number, state, age, sex, zip code, and carrier name. Ensure that all fields are filled accurately.
3. In the health history section, the driver should answer questions regarding any illnesses or injuries that occurred in the past five years. For any affirmative answers, provide details such as condition, onset date, diagnosis, treating medical examiner's name, and additional comments.
4. List all medications currently being used, including over-the-counter medications. You may also note any additional comments on an attached DS-874C form.
5. Proceed to the testing section, where the medical examiner will fill out specifics regarding vision, blood pressure, pulse rate, hearing, urinalysis, physical examination findings, and any other required tests.
6. For each test, ensure that the examiner records the appropriate details, such as numerical readings for vision and blood pressure, and observations regarding each relevant body system.
7. In the medical examiner's certification section, the examiner will indicate whether the driver is physically or medically qualified, any restrictions or follow-up requirements, and will provide their comments.
8. The medical examiner must sign and date the form while also providing their credentials, ensuring all information is accurate and complete.
9. Once all sections are filled, review the form for any errors before saving any changes. You may choose to download, print, or share the completed NY DS-874 form.

Complete your NY DS-874 form online for a seamless examination process.