Things to bring with you to your DOT Physical Exam

  1.  Print and complete The Medical Examiner Form (Pages 1 & 2)
  2. Bring a complete list of ALL of the medications (and the names of the prescribing providers) you are taking including prescription, over-the-counter, herbal remedies, and dietary supplements.
  3. Glasses/Contacts if you need them for driving.
  4. If you have:
        • Heart Disease, including valve replacements:  A letter from your cardiologist addressing the cardiac condition and medications used including a statement indicating whether it will impact your ability to operate a CMV.  You may also require the results of an echocardiogram and cardiac stress test within the past 1-2 years.  If you take Coumadin, please provide an INR result within the last month.

        • Diabetes:  Your most recent hemoglobin A1C value (usually within 3 months).  You also may be required to get a letter from your treating physician specifically addressing your diabetes.

        • Sleep Apnea:  Sleep Apnea Compliance Report with at least 60 days but preferably 6 months of data
        • Mental health conditions such as depression, anxiety, or ADHD/ADD: A letter from your treating provider addressing the condition, any medication used, and whether the condition or medication(s) will impact your ability to operate a CMV.

        • Cancer:  A letter from your treating provider/oncologist addressing the condition, any medication used, and whether the condition or medication(s) will impact your ability to operate a CMV.

        • Neurological conditions such as stroke, tremors, seizures or neuropathy:  A letter from your treating neurologist addressing the condition including date of onset, any medication used, and whether the condition or medication(s) will impact your ability to operate a CMV.

        • Recent surgery:  A letter from the surgeon addressing the condition/surgery, any current medication used, and whether you have any current limitations that would impact your ability to operate a CMV.

        • Narcotic Usage:  A letter from the prescribing physician stating the medical condition for which they are used, current medication/dosage, side effects, and a statement indicating whether or not he/she believe it is safe to operate a commercial motor vehicle while using these medications.    

PLEASE NOTE: IF YOU DO NOT HAVE THE APPROPRIATE DOCUMENTATION, YOU MAY BE ASKED TO RESCHEDULE YOUR EXAM 

The above list of medical conditions is for informative purposes only and does not include all medical issues.  If you are unsure about a medical condition that you have, please bring a letter from your provider.

Please note that having a medical examination and documentation from your providers is not a guarantee of receiving a medical card.  Additional tests may be required including on the date of your examination which may require an additional fee, such as an audio booth hearing examination and/or an ECG.  Fees for these services are available upon request.

www.middlesexhospital.org/DOT

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