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Get Medical Examination Report Form Class 1, Class 2 & Class 3 Applicants
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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.
- Click ‘Get Form’ button to obtain the form and open it in the editor.
- Identify the examination category at the top of the form — select between Initial, Renewal, Revalidation, or Special referral.
- Fill in the applicant's personal details, including height, weight, eye color, and hair color in the designated fields.
- Record the applicant's blood pressure while seated: note the systolic and diastolic readings.
- Document the resting pulse rate in beats per minute (bpm).
- Conduct clinical examinations: assess items like head, face, mouth, eyes, lungs, heart, etc., marking each as either Normal or Abnormal.
- For any abnormal findings, refer to section (228) and provide descriptions, noting the related item number.
- Evaluate visual acuity by entering results for distant, intermediate, and near vision tests for each eye.
- Complete the pulmonary function section, if required, including FEV1/FVC results.
- Perform urinanalysis checks and record results for glucose, blood, and protein; mark as Normal or Abnormal.
- Attach any accompanying reports such as ECG, audiogram, and ophthalmology if applicable.
- 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.
- Complete the AME declaration by providing the AME's name, address, signature, and contact details.
- 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.
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.