DOT Physical Forms: MCSA-5875 and MCSA-5876 Explained

The two main DOT physical forms are MCSA-5875, the Medical Examination Report, and MCSA-5876, the Medical Examiner’s Certificate. The first documents the driver’s medical history and examination findings. The second records the medical examiner’s certification decision when the driver is found qualified. They serve different purposes and are not interchangeable.

Form MCSA-5875: Medical Examination Report

The Medical Examination Report (MER), Form MCSA-5875, is the detailed record used during a federal commercial driver medical examination. It includes driver identification, medical history, examination information, and the examiner’s findings.

The driver completes the medical history portion accurately and reviews relevant questions with the examiner. The examiner conducts the assessment and documents the examination results and qualification determination. Completing the driver’s portion does not establish medical qualification.

Drivers can access the current official form through the FMCSA MCSA-5875 page. The examiner’s office may use a paper workflow or an appropriate electronic process, so ask how it wants the information supplied.

The completed examination report is maintained as part of the examiner’s required records. It contains personal medical information and is different from the certificate ordinarily used to document medical qualification.

Form MCSA-5876: Medical Examiner’s Certificate

The Medical Examiner’s Certificate (MEC), Form MCSA-5876, is completed by the medical examiner when the driver is determined to be medically qualified under the applicable standards. It identifies the certification decision and relevant qualification information.

A certificate may be issued for up to 24 months, but the examiner can determine that a shorter period is appropriate. The examination report and certificate should reflect the same qualification decision.

The certificate is not a blank document that a driver can complete to self-certify medical fitness. A driver’s signature or possession of an unused form does not replace the examiner’s assessment.

Use the official FMCSA MCSA-5876 page when reviewing the certificate format rather than relying on an undated copy from another website.

Are Other DOT Medical Forms Required?

Some examinations involve additional documentation. Which forms are relevant depends on the circumstances and the examiner’s assessment, not on a standard requirement for every driver to complete every available medical form.

• MCSA-5870: Insulin-Treated Diabetes Mellitus Assessment Form, completed by the treating clinician when the applicable federal process requires it.
• MCSA-5871: Vision Evaluation Report, used in circumstances covered by the federal vision standard and completed by the appropriate eye care professional.
• MCSA-5872: An optional assessment form concerning non-insulin-treated diabetes.
• MCSA-5895: An optional form used to obtain information about prescribed medication from a treating clinician.

These forms have different purposes and are not substitutes for MCSA-5875 or MCSA-5876. The FMCSA medical forms resource page identifies the available forms and their intended applications.

If the examiner requests additional records, arrange their delivery directly through the examiner’s specified process. Avoid sending medical histories, treatment records, or completed medical forms through a general commercial provider inquiry form.

Where to Find Current DOT Physical Paperwork

Use FMCSA’s current form landing pages as the starting point. These pages provide access to official documents and help avoid outdated copies downloaded from unrelated websites.

You may notice an Office of Management and Budget (OMB) approval expiration date printed on a federal form. That administrative date is not the expiration date of an individual driver’s medical certificate. The driver’s certification period is determined through the examination process and appears on the applicable certificate.

Before printing forms, ask whether the examiner’s office supplies its own current documents or uses electronic records. Bringing an independently downloaded form is not necessarily required when the office already has an established examination workflow.

What Happens to the Forms After the Examination?

The examiner retains the required examination records and reports applicable results through the National Registry system. For commercial learner’s permit and commercial driver’s license holders, examination results are integrated with state licensing records.

Drivers should follow their home State Driver Licensing Agency’s current instructions and check their recorded medical certification status. Do not assume that every state record changes immediately when the appointment ends.

It is also important to distinguish examination paperwork from drug testing documentation. Urinalysis performed as part of the DOT medical examination is not the same as a regulated DOT drug test. Employment-related testing follows a separate process, explained in our DOT pre-employment drug testing services guide.

If you need an examiner rather than copies of the forms, you can explore the DOT physical provider directory and submit a provider inquiry for your preferred examination location.