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Missouri Motor Carrier Safety Compliance Manual-April, (2018
Form MCSA-5875. OMB No. 2126-0006 Expiration Date: 11/30/2021. Last Name: First Name: Exam Date: DOB: Please complete only one of the following (Federal or
Medical Examination Report (MER) Form, MCSA-5875 | FMCSA
30 Mar 2022 As part of the physical, drivers are required to fill out the medical history portion of the Medical Examination Report (MER) Form, MCSA-5875.
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