Medical qualification

DOT physical form: what to fill in

CDLP editorial · 5 min read
Published Nov 2, 2026 · Updated Nov 8, 2026

What is the DOT physical form, and what's on it?

The DOT physical form usually means Form MCSA-5875, the Medical Examination Report: you fill in your details and health history. The examiner records the exam and decision. Form MCSA-5876 is the separate Medical Examiner’s Certificate.

The extra reports you need depend on your case and the rules. FMCSA labels MCSA-5870 for insulin-treated diabetes and MCSA-5871 for vision evaluation. Download forms from FMCSA, give honest answers and ask the examiner what to bring.

Filling in your section does not mean you pass.

If this is your situation, start here
Your situation	Start with…
You need a blank form	Match the form number to its purpose
You are filling in your history	Prepare Section 1
You need a diabetes or vision report	Check the report’s timing

The report records the exam. The certificate shows whether you qualify. Start with FMCSA’s Medical Examination Report page and its Medical Examiner’s Certificate page, both opened November 2, 2026. Ask if the office supplies the form. It may ask you to fill in its own forms before arrival.

More detail and source notes

For appointment preparation, use the full DOT physical guide. This page explains paperwork, not treatment or an individual pass/fail decision.

Studying for the license exam too? Use the free general knowledge practice test alongside your state manual.

Match the form number to its purpose

FMCSA medical forms — checked November 2, 2026
Form	Purpose	Who completes the clinical portion
MCSA-5875	Medical Examination Report (MER): driver information, history, examination and determination.	Driver completes Section 1; examiner completes Section 2.
MCSA-5876	Medical Examiner’s Certificate (MEC): the separate qualification certificate.	Medical examiner; follow the form’s driver signature instructions.
MCSA-5870	Insulin-Treated Diabetes Mellitus Assessment Form.	Treating clinician for the insulin-treated diabetes certification process.
MCSA-5871	Vision Evaluation Report for the alternative vision-standard process.	Ophthalmologist or optometrist.

These reports help the examiner assess your health. Neither replaces the exam report. The form numbers matter when you arrange a specialist appointment.

Section 1: your identity and health history

The official report and completion instructions, revision March 27, 2025, checked November 2, 2026, ask for your identity and license details, prior medical-certification history, surgery, medications and health history. Use the name on your license. The office checks your ID.

More about Section 1: your identity and health history

Give honest answers and explain them when needed. Use “not sure” if you do not know. List the drugs the form asks about. This includes prescribed drugs and those you buy without a prescription. Read the statement before you sign and date it. Ask the examiner about any unclear question. Do not hide facts to make the visit easier.

Section 2: the examiner records findings

The examiner reads your history and asks about your answers. They record the tests and exam, then make the decision. Under 49 CFR 391.43, results belong on MCSA-5875. Rule and form checked November 2, 2026.

Let the examiner record clinical measurements and decide if you qualify. If blood pressure is your concern, read the dated blood-pressure certification guidance and bring questions about your own records. Copying a number into a blank form cannot prove you pass.

Additional diabetes or vision reports have their own timing

FMCSA’s MCSA-5870 instructions for insulin-treated diabetes require a treating clinician’s assessment and provision to the certified examiner within 45 days of completion. Its MCSA-5871 vision report instructions describe an ophthalmologist’s or optometrist’s signed report, with the medical examination beginning within 45 days of signing. Both checked November 2, 2026.

Ask the examiner whether either pathway applies before arranging reports. These reviews have different purposes. Ask your own clinician about diagnosis, drugs and treatment.

After the exam: confirm the decision and record

The examiner signs the report and explains the result. The examination and reporting rule, checked November 2, 2026, also covers pending examinations, reporting and record retention. If more information is needed, get the requested item and deadline directly from the office.

More about After the exam: confirm the decision and record

Ask how your licensing state receives and records medical status and how to check that record. Paperwork handed to a school is not proof of a state-record update. Use the broader CDL license rules to keep that handoff separate from permit and skills testing.

Your next-step checklist

I obtained the current form through FMCSA or the examiner.
My name and license details match my identification.
My history, medications and explanations are accurate.
I asked which supporting clinician reports apply.
I know the actual result, follow-up and state-record next step.

Use this as a planning checklist. Selections stay on this page and are not submitted.

Questions drivers ask

Is MCSA-5875 the medical card?

No. MCSA-5875 is the examination report. MCSA-5876 is the separate Medical Examiner’s Certificate.

Do I fill in the examination results?

The medical examiner completes Section 2. You complete the driver information and health history in Section 1 and discuss unclear questions with the examiner.

Which form is for diabetes and which is for vision?

FMCSA identifies MCSA-5870 as the Insulin-Treated Diabetes Mellitus Assessment Form and MCSA-5871 as the Vision Evaluation Report.

Does a treating clinician’s report guarantee certification?

No. It supplies information for the medical examiner’s assessment under the standards that apply.

Where should I send my health history?

Use the examiner’s verified intake process. Ask the office which records it needs and how to provide them securely.

Put the answers to work.

Use the same questions when you compare your training options.

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Sources and scope

Source links, check date and scope

Sources checked Nov 2, 2026. Federal baselines and named state examples are distinguished in the article. Your licensing agency and written program terms govern your case.

Prepared by CDLP editorial from the sources above. No independent instructor, legal or financial review is claimed.