Certificate B 328 Form PDF Details

Navigating the realm of professional driving, especially within Connecticut, requires more than just skill behind the wheel. The Certificate B 328 form, a pivotal document issued by the State of Connecticut's Department of Motor Vehicles (DMV), serves as a testament to a driver's medical fitness for navigating the challenges of the road. Tailored to align with the rigorous standards set forth by the Federal Motor Carrier Safety Regulations (49 CFR 391.41-391.49), this certificate underscores a driver's health status in relation to their driving duties. By undergoing a meticulous examination, drivers are evaluated for their physical and sensory capabilities, including the necessity for corrective lenses or hearing aids, their ability to operate within exempt intracity zones, or the need for a Skill Performance Evaluation (SPE) Certificate or any other specified waiver/exemption. Crucial to note is that this form, once completed by a qualified medical examiner—who may range from physicians to advanced practice nurses and chiropractors—remains within the personal file of the commercial driver, emphasizing its significance not just as a formality but as a cornerstone of road safety and compliance. The details, including the examiner's declaration of the driver's qualification status, medical certificate expiration, and other pertinent information, solidify this document's role in ensuring only the fit and fully capable are at the helm of commercial vehicles.

QuestionAnswer
Form NameCertificate B 328 Form
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesct dmv medical card self certification, cdl medical card ct, ct dmv cdl medical card fax number, ct dmv medical card

Form Preview Example

MEDICAL EXAMINER'S CERTIFICATE

STATE OF CONNECTICUT - DMV

B-328 Rev. 10-2008

On The Web At ct.gov/dmv

I CERTIFY THAT I HAVE EXAMINED (PRINT NAME OF INDIVIDUAL BELOW)

In accordance with the Federal Motor Carrier Safety Regulations (49 CFR 391.41-391.49) and with knowledge of the driving duties, I find this person is qualified; and, if applicable, only when:

Please keep this card

Wearing Corrective Lenses

Wearing Hearing Aid

Qualified by operation of 49 CFR 391.64

Driving within an exempt intracity zone (49 CFR 391.62)

Accompanied by a Skill Performance Evaluation Certificate (SPE)

Accompanied by a ____________________________ waiver/exemption

for your record do not mail to the DMV.

The information I have provided regarding this physical examination is true and complete. A complete examination form with any attachment embodies my findings completely and correctly, and is on file in my office.

 

SIGNATURE OF MEDICAL EXAMINER

TELEPHONE NUMBER

DATE

 

X

 

 

 

 

 

 

 

 

 

 

 

 

NAME OF MEDICAL EXAMINER (PLEASE PRINT)

ISSUING STATE

 

MEDICAL CERTIFICATE EXPIRATION DATE

 

 

 

 

 

 

 

 

MEDICAL EXAMINER'S LICENSE OR CERTIFICATE NO.

MD

DO

Physician

Advanced

 

 

 

 

Chiropractor

Assistant

Practice Nurse

SIGNATURE OF DRIVER

DRIVER'S LICENSE NUMBER

STATE

 

X

 

 

 

 

 

 

 

 

 

 

 

 

ADDRESS OF DRIVER

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