Cdl Med 1 Form PDF Details

The CDL-MED-1 form, integral for commercial drivers in the state of North Carolina, outlines a crucial process for maintaining compliance with medical certification requirements. This document, revised in December 2013, serves as a certification for drivers who operate or intend to operate commercial motor vehicles (CMVs) within interstate or intrastate commerce. It distinguishes between four types of operations: non-excepted interstate, excepted interstate, non-excepted intrastate, and excepted intrastate, each with its specific compliance criteria under various parts of the Code of Federal Regulations (CFR), particularly part 391. Depending on the chosen classification, the driver might need to present a medical examiner's certificate to the North Carolina Department of Transportation, Division of Motor Vehicles (NCDMV), signifying their health and fitness for operating a CMV. Furthermore, the form details the methods for submitting the necessary medical certification documents, offering options through email, postal service, or in-person delivery at local DMV offices. This ensures that all commercial drivers, regardless of their operation type, can efficiently remain in good standing, maintaining the safety and reliability crucial to their profession. The form also emphasizes the importance of accuracy and truthfulness through a certification under penalty of perjury, underscoring the serious commitment of drivers to their roles and responsibilities within the transportation network.

QuestionAnswer
Form NameCdl Med 1 Form
Form Length1 pages
Fillable?Yes
Fillable fields13
Avg. time to fill out2 min 55 sec
Other namesncdot medical card certification, nc cdl medical card, cdl medical ncdot, nc dot cdl medical form

Form Preview Example

CDL-MED-1 (Rev. 12/13)

State of North Carolina

North Carolina Department of Transportation

Division of Motor Vehicles

MEDICAL CERTIFICATION

of Driver Type

FOR COMMERCIAL DRIVER LICENSE

Name

(First)

( Middle)

(Last )

(Suffix)

North Carolina License Number:

Social Security Number

Date of Birth:

CHECK THE APPROPRIATE BOX FOR THE TYPE OF OPERATION THAT APPLIES TO YOU

ONLY ONE BOX MAY BE CHECKED

NON-EXCEPTED INTERSTATE: operates or expects to operate in interstate commerce, is both subject to and meets the qualification requirements under 49 CFR part 391, and is required to obtain a medical examiner’s

certificate by 391.45. Commercial driving operation is permitted across state lines and you are required to meet Federal medical requirements. (Required to have a DOT medical card/certificate)

EXCEPTED INTERSTATE: operates or expects to operate in interstate commerce, but engages exclusively in

transportation or operations excepted under 49 CFR 390.3(f), 391.2, 391.68 or 398.3 from all or parts of the qualification requirements of 49 CFR part 391, and is, therefore, not required to obtain a medical examiner’s

certificate. Commercial driving operation is permitted across state lines for excepted operation only and you are exempt from the Federal medical requirements.

NON-EXCEPTED INTRASTATE: This certification category is for applicants that will only drive a CMV in intrastate commerce and are required to meet the medical requirements for NC. A medical examiners

certificate will be required. (Required to have a DOT medical card/certificate and license has restriction “K")

EXCEPTED INTRASTATE: operates in intrastate commerce but, engages exclusively in transportation or operations excepted from all or parts of the State driver qualification requirements. Commercial driving operation

is restricted to NC, permitted for excepted operation only and you are exempt from the Federal medical requirements. (License has restriction “K")

I certify under penalty of perjury that all statements above are true and correct.

Signature:Date:

Please use only one method for submitting your certification documents.

1.Please email all medical certification documents to: CDLmedical@ncdot.gov

2.Please mail all medical certification documents to: NCDMV

Data Capture Imaging Unit

3126 Mail Service Center

Raleigh, NC 27699-3126

3.You may deliver your medical certification documents to your local DMV office. A list of office locations and hours can be found on our website www.ncdot.gov/dmv. If you have any questions please contact the DMV Customer Call Center at (919) 861-3599.

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Guidelines on how to prepare dot medical card nc portion 1

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