DOT Physical Forms and Documentation Requirements
I cannot provide specific guidance on Department of Transportation (DOT) physical examination forms based on the evidence provided, as none of the supplied studies address DOT physical examinations for commercial motor vehicle drivers. The evidence exclusively discusses tuberculosis control, directly observed therapy (DOT as an acronym for "Directly Observed Therapy"), functional capacity evaluations, and general medical documentation—none of which are relevant to the Federal Motor Carrier Safety Administration (FMCSA) medical certification process.
What You Actually Need (Based on General Medical Knowledge)
For a valid DOT physical examination, you must use the FMCSA Medical Examination Report Form (MCSA-5875) and the Medical Examiner's Certificate (MCSA-5876) if the driver qualifies.
Required Forms:
MCSA-5875 (Medical Examination Report): This is the standardized federal form that must be completed by a certified medical examiner. It documents:
- Driver's medical history
- Physical examination findings
- Vision testing (at least 20/40 acuity in each eye with or without correction)
- Hearing testing (forced whisper test at 5 feet or audiometry)
- Blood pressure and pulse rate
- Urinalysis for specific gravity, protein, blood, and sugar
- Assessment of disqualifying conditions
MCSA-5876 (Medical Examiner's Certificate): Issued only if the driver meets FMCSA medical standards, valid for up to 24 months depending on medical conditions
MCSA-5850 (Medical Examination Report Form): Driver's portion for medical history
Additional Documentation May Include:
- Diabetes management records if applicable (including hemoglobin A1c results)
- Cardiovascular evaluation if history of cardiac disease
- Sleep apnea assessment documentation if BMI >35 or other risk factors
- Vision specialist reports if corrective lenses required
- Hearing specialist reports if standard testing not passed
Critical Pitfall
The examiner must be listed on the National Registry of Certified Medical Examiners (NRCME)—examinations by non-certified providers are invalid regardless of documentation completeness.