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MEDICAL EXAMINATION REPORT &

DOCTOR CERTIFICATION FORM

Link to Form MCSA-5875 (Revised: 12/09/2015)

Medical Examination Report Form (for Commercial Driver Medical Certification)

https://nationalregistry.fmcsa.dot.gov/ResourceCenter/documents/MCSA-5875%20final%20508.pdf

Link to Form MCSA-5876 (Revised: 12/06/2015)
Medical Examiner's Certificate (for Commercial Driver Medical Certification)

https://nationalregistry.fmcsa.dot.gov/ResourceCenter/documents/MCSA-5876%20final%20508.pdf


Link to DMV FORM DL 51 // Medical Examination Report For Commercial Driver Fitness Determination.

https://apps.dmv.ca.gov/forms/dl/dl51.pdf


OTHER DOT FORMS

 http://www.fmcsa.dot.gov/medical/driver-medical-requirements/medical-applications-and-forms