First published by NDASA
Keep Using the DOT Medical Exam Forms Expiring Today
The date found on the top right corner of the following forms indicate the date of expiration is today, November 30th, 2021
- Form MCSA-5875 – Medical Examination Report
- Form MCSA-5876 – Medical Examiner’s Certificate
- Form MCSA-5870 – Insulin-Treated Diabetes Mellitus Assessment
This is the date of expiration for the Office of Management and Budget (OMB) approved information collection 2126-0006.
FMCSA is in the process of submitting the information collection renewal request for approval. Please continue to use the forms that are currently posted on the FMCSA website.
Once the information collection renewal has been approved, new versions of the Medical Examination Report Form, MCSA-5875, Medical Examiner’s Certificate, MCSA-5876, and Insulin-Treated Diabetes Mellitus Assessment Form, MCSA-5870 will be posted on the FMCSA website indicating the forms have been renewed.
View the current form here: FMCSA Form MCSA-5875 (dot.gov)
McCraren Compliance can help you understand and comply with FMCSA, USDOT and ADOT and ensure your drivers and your vehicles operate safely and efficiently.
Call us Today at 888-758-4757 or email us at email@example.com to schedule your free FMCSA Compliance Assessment.