• Gilbert, AZ — serving the Phoenix East Valley
  • Walk‑ins welcome
  • $75 cash / $85 card
(480) 649-5869

Health Forms in Gilbert, AZ

Some health conditions mean you'll need to bring a medical clearance letter in Gilbert AZ to your exam. When you make your appointment, we'll ask a few questions to see if you need one — and email you the right form for your situation.

  • We'll tell you if you need one
  • Form emailed to you
  • Free PDF downloads
DOT physical health forms at DOT Physical Phoenix in Gilbert, AZ
How It Works

Getting the Right Form Is Easy

1

Book your exam

When you make your appointment, we'll ask you a few health questions.

2

We email the form

If your condition needs a clearance form, we'll email you the one you need.

3

Bring it completed

Have your doctor or specialist fill it out, then bring it to your DOT physical.

Mandatory Forms

Forms Needed for These Conditions

Find your condition below and download the form your doctor needs to complete.

MCSA-5870

Insulin-Treated Diabetes Mellitus

ITDM Assessment Form

  • Valid 45 days
  • Recertify every 12 months

Since November 2018, drivers who use insulin can be certified without an FMCSA exemption, as long as they're recertified every 12 months and meet certain physical requirements.

Before your DOT physical, your treating clinician completes this form to confirm you have a stable insulin regimen and properly controlled diabetes. The medical examiner reviews it during your exam.

MCSA-5871

Monocular Vision

Vision Evaluation Report

  • Valid 45 days
  • Reassess every 12 months

Since March 2022, drivers with vision in only one eye follow the alternative vision standard, which replaces the old Federal vision exemption.

Get this report from a licensed ophthalmologist or optometrist. It covers visual acuity, field of vision, and color recognition. Bring it to your DOT physical for the medical examiner to review.

MCSA-5895

CMV Driver Medication Form

391.41 CMV Driver Medication Form

  • Optional form
  • For drivers on medication

This optional form helps the certified medical examiner learn more about medications prescribed by your doctor, especially ones that could affect your ability to drive a CMV safely.

If you take medication, talk with your doctor about whether it could affect your driving, have them complete this form, and bring it to your exam.

DOT Physical Phoenix office location in Gilbert, AZ
Driver-Friendly DOT Physical Exams

Get In & Out On Time!

Walk-ins welcome.

Office Hours

  • Monday8:30 AM – 12:00 PM
    2:00 PM – 6:00 PM
  • Tuesday8:30 AM – 2:00 PM
  • Wednesday8:30 AM – 12:00 PM
    2:00 PM – 6:00 PM
  • Thursday8:30 AM – 12:00 PM
    2:00 PM – 6:00 PM
  • Friday8:30 AM – 2:00 PM
  • Saturday & SundayClosed

Drug testing stops 2 hours before closing.

201 W Guadalupe Rd, Suite 311B
Gilbert, AZ 85233

Ready to Get Your DOT Physical?

Fast. Affordable. Driver-Friendly. Get your DOT/CDL physical and get back to work.

$75 Cash  |  $85 Card

Walk-ins welcome

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