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  1. 31 sie 2018 · 2024 Medical Certification Forms MCSA-5875 & MCSA-5876. New expiration date on the forms is 03/31/2025. PDF Versions of the forms are available at these links on the FMCSA website: Medical Examination Report (MER) Form, MCSA-5875; Medical Examiner’s Certificate (MEC), Form MCSA-5876

  2. OOD Communication Disability Verification Form: ood.ohio.gov : BMV 0399: Driver License/ID Cards: Request for Service by State or County Agency: PDF Word: BMV 1152: ... Motor Vehicle Physical Inspection for Ohio Residents and Military Personnel Temporarily Living Out-of-State: PDF Word: BMV 3804: Titles: Affidavit Conversion to Motor Home: PDF ...

  3. Commercial Driver License Self Certification Authorization Form – download the form here from Ohio Department of Public Safety Bureau of Motor Vehicles. Copy of your valid DOT medical card (medical card only, not the long form).

  4. OSHA Respirator Medical Evaluation Questionnaire (PDF, 611 KB) – Please complete and print this form before your respirator evaluation. Baseline Asbestos Questionnaire (PDF, 577 KB) – Please print and complete this required form before your baseline asbestos medical surveillance exam.

  5. 20 gru 2023 · As part of the physical, drivers are required to fill out the medical history portion of the Medical Examination Report (MER) Form, MCSA-5875. Last updated: Wednesday, December 20, 2023.

  6. 23 wrz 2022 · Ensure that the Physicians T8 form is attached to the correct driver/employer T8 form. Review the form to ensure the physician’s signature and results are legible on all pages. A form must be complete and all of the assessments marked as P for the physical to be considered as a valid passing exam.

  7. 20 lut 2024 · Medical Examiners should start using the forms with the 12/31/2024 date as soon as possible.

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