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  • Medical Examination Report Form Class 1, Class 2 & Class 3 Applicants

Get Medical Examination Report Form Class 1, Class 2 & Class 3 Applicants

Medical Examination Report form class 1, class 2 & class 3 applicants (201) Examination Category(202) HeightInitial Renewal Revalidation Special referral(204) Colour Eye(203) Weight(205) Colour.

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How to fill out the Medical Examination Report Form Class 1, Class 2 & Class 3 Applicants online

Filling out the Medical Examination Report Form for Class 1, Class 2, and Class 3 applicants is an essential step in ensuring that all health requirements are met. This guide provides clear, step-by-step instructions to assist users in completing the form thoroughly and accurately online.

Follow the steps to successfully complete the form online.

  1. Click ‘Get Form’ button to obtain the form and open it in the editor.
  2. Identify the examination category at the top of the form — select between Initial, Renewal, Revalidation, or Special referral.
  3. Fill in the applicant's personal details, including height, weight, eye color, and hair color in the designated fields.
  4. Record the applicant's blood pressure while seated: note the systolic and diastolic readings.
  5. Document the resting pulse rate in beats per minute (bpm).
  6. Conduct clinical examinations: assess items like head, face, mouth, eyes, lungs, heart, etc., marking each as either Normal or Abnormal.
  7. For any abnormal findings, refer to section (228) and provide descriptions, noting the related item number.
  8. Evaluate visual acuity by entering results for distant, intermediate, and near vision tests for each eye.
  9. Complete the pulmonary function section, if required, including FEV1/FVC results.
  10. Perform urinanalysis checks and record results for glucose, blood, and protein; mark as Normal or Abnormal.
  11. Attach any accompanying reports such as ECG, audiogram, and ophthalmology if applicable.
  12. At the conclusion of the form, enter the recommendation from the Aeromedical Examiner (AME), specifying if the applicant is fit or unfit for their class.
  13. Complete the AME declaration by providing the AME's name, address, signature, and contact details.
  14. Finally, review the form to ensure all fields are accurately filled out, then save changes or download, print, or share the completed form.

Complete your Medical Examination Report Form online today to ensure a seamless application process.

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If the Medical Examiner determines that the driver examined is physically qualified to drive a commercial motor vehicle in ance with the physical qualification standards, the Medical Examiner will complete and provide the driver with a Medical Examiner's Certificate (MEC), Form MCSA-5876.

About the Medical Examination Report (MER) Form, MCSA-5875: The Federal Motor Carrier Safety Administration requires that interstate commercial motor vehicle drivers maintain a current Medical Examiner's Certificate (MEC), Form MCSA-5876 to drive.

What is a DOT medical certification? The Department of Transportation medical certification is a certifying credential commercial drivers complete to demonstrate physical, mental and emotional fitness to perform in a commercial driving role.

If the Medical Examiner determines that the driver examined is physically qualified to drive a commercial motor vehicle in ance with the physical qualification standards, the Medical Examiner will complete and provide the driver with a Medical Examiner's Certificate (MEC), Form MCSA-5876.

How to submit a Medical Certificate to the Medical Certification Unit. Email: dmv.sm.cdlmedcertunit@dmv.ny.gov Put your first and last name in the subject line. In the event that you need to confirm receipt of your e-mailed medical certificate, DMV will track it using the information in the subject line.

All Missouri CDL holders are required to certify the type of commercial operation they're engaged in. You must meet the Federal DOT medical certificate requirements. You must meet the Federal DOT medical certificate requirements.

DOT Certified Medical Examiners are those who have gone through the training and certification needed to be recognized by the Department of Transportation as a medical professional who can carry out the exams on these drivers.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232