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