Due to certain health conditions, you may be required to bring to your exam a medical clearance letter in Gilbert AZ. When you make your appointment, we will ask you several questions to determine if these forms are needed. We will email you the medical clearance form that is needed for your situation.
MANDATORY FORMS THAT ARE NEEDED FOR THESE CONDITIONS
In November 2018, standards were revised to permit insulin use in CMV drivers with insulin-treated diabetes mellitus, providing a medical certification is acquired every 12 months and certain physical requirements are met. FMCSA exemptions are therefore no longer required for insulin users.
If you have insulin-treated diabetes, you must now get an evaluation from your treating clinician before your DOT physical. ITDM Assessment Form, MCSA-5870, which evaluates whether you have a stable insulin regimen and properly controlled diabetes mellitus. Once completed, this form is valid for 45 days and will be evaluated by the medical examiner during your DOT physical.
Insulin Treated Diabetes Mellitus (ITDM) Assessment Form, MCSA-5870
In March 2022, the vision standard for the DOT physical was amended now have to follow the provisions adopted in the new alternative vision standard rather than seeking a Federal vision exemption.
Drivers with monocular vision must obtain a Vision Evaluation Report, Form MCSA-5871, from a licensed ophthalmologist or optometrist covering visual acuity, field of vision and recognition of colors. This report is valid for 45 days and must be taken to your DOT physical for consideration by the medical examiner. Those qualified under the alternative vision standard must be reassessed every 12 months. This replaces the Federal vision exemption.
MANDATORY FORMS THAT ARE NEEDED FOR THESE CONDITIONS
Monday
8:30 am – 12:00 pm
2:00 pm – 6:00 pm
Tuesday
8:30 am – 2:00 pm
Wednesday
8:30 am – 12:00 pm
2:00 pm – 6:00 pm
Thursday
8:30 am – 12:00 pm
2:00 pm – 6:00 pm
Friday
8:30 am – 2:00 pm
Weekends
Closed
201 W Guadalupe Rd Suite 311B, Gilbert, AZ 85233
480-649-5869
Dr. Howard Fern, DC, FIAMA, CME
201 W Guadalupe Rd Suite 311B, Gilbert, AZ 85233
(480) 649-5869
Monday, Wednesday & Thursday :
8:30 AM – 12:00 PM & 2:00 PM – 6:00 PM
Tuesday & Friday :
8:30 AM – 2:00 PM
Walk-ins are Welcome!
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