Please rate Dot Medical Form Mcsa-5875, Rev 3-27-2025
As the Medical Examiner conducting the driver's physical examination you are required to complete the entire medical examination even if you detect a medical condition that you consider disqualifying.
Testing: urinalysis is required. Numerical readings must be recorded.
Vision: standard is at least 20/40 acuity (Snellen) in each eye with or without correction.
Hearing: hearing can be tested using either a whisper test or audiometric test.
Pending: determination pending allows for a delay of the qualification decision for as many as 45 days.
| Question | Answer |
|---|---|
| Form Name | Form MCSA-5875 |
| Form Length | 9 pages |
| Fillable? | Yes |
| Fillable fields | 203 |
| Avg. time to fill out | 34 min |
| Edition | 3/27/2025 |
| Issuing agency | Federal Motor Carrier Safety Administration |
| Other names | MCSA-5875, MCSA 5875, Form MCSA-5875, Medical Examination Report Form |
| Official source | Form MCSA-5875 (Rev 3/27/2025), Federal Motor Carrier Safety Administration |
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Please rate Dot Medical Form Mcsa-5875, Rev 3-27-2025
