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The Initial Reporting Form can be used by emergency rooms or other health care personnel who do not have access to the patient’s medical history or do not have enough knowledge about a specific medical condition to complete the appropriate form.
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.
20 lut 2024 · The expiration date on the Medical Examination Report Form, MCSA-5875, Medical Examiner's Certificate, MCSA-5876, Insulin-Treated Diabetes Mellitus Assessment Form, MCSA-5870, and the Vision Evaluation Report, Form MCSA–5871 has been updated to 12/31/2024, and all forms are posted below.
A Medical Examiner's Certificate is a document you get from your doctor after a physical checkup. It says that you're fit to drive a commercial vehicle. Your doctor fills out the form, gives you one copy, and keeps another for at least 3 years. Most commercial drivers need to submit their Medical Examiner’s Certificate to PennDOT.
20 gru 2023 · If the Medical Examiner determines that the driver examined is physically qualified to drive a commercial motor vehicle in accordance with the physical qualification standards, the Medical Examiner will complete and provide the driver with a Medical Examiner's Certificate (MEC), Form MCSA-5876.
15 gru 2021 · The Insulin-Treated Diabetes Mellitus Assessment Form (MCSA-5870). Key to remember: New DOT medical forms have been approved, but examiners may continue to use existing forms for driver physical exams until the new forms are available.
Medical Examiner’s Certificate (DOT PHYSICAL CARD). • Please enlarge your Medical Examiner’s Certificate to 5 inches by 7 inches and make sure that all of the health care provider information is complete and legible.
