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How to fill out the MCSA-5876 online
The MCSA-5876 form, known as the Medical Examiner's Certificate, is essential for commercial driver medical certification. This guide provides step-by-step instructions on how to accurately complete this important document online.
Follow the steps to fill out the MCSA-5876 effectively.
- Press the ‘Get Form’ button to access the form and open it in the editor.
- Begin by entering the last name and first name of the individual being examined in the designated fields.
- Select one of the applicable certifications based on the Federal Motor Carrier Safety Regulations by checking the appropriate box, ensuring accuracy.
- If there are any conditions such as wearing corrective lenses or a hearing aid, check the corresponding boxes under ‘if applicable’.
- Provide details regarding exemptions by checking any relevant options, including qualifications by operation or being grandfathered from state requirements.
- Complete the section confirming the truthfulness of the provided information regarding the physical examination.
- The medical examiner must then sign and date the certificate, including their printed name, phone number, and medical license details.
- Enter the driver's signature along with their driver’s license number, issuing state, and address including street, city, and zip code.
- Review all entries to ensure completeness and accuracy, then save your changes.
- Once finished, download, print, or share the completed form as necessary.
Complete your MCSA-5876 form online today to ensure compliance and proper documentation.
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Generally, only certified medical examiners are authorized to conduct DOT physicals, which means a nurse cannot perform these examinations unless they have received the necessary certification. Nurses can, however, assist in preparing documentation or initial evaluations. To ensure compliance and receive the correct MCSA-5876 certificate, drivers must seek an appropriate medical examiner.
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