Mcsa 5896 form-2025

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A Department of Transportation (DOT) physical examination must be conducted by a licensed medical examiner listed on the Federal Motor Carrier Safety Administration (FMCSA) National Registry.
This form can be used to submit requests for Operating Authority name and address changes, and also to request reinstatement of an operating authority. Forms can be submitted via our web form or by fax to 202-366-3477.
As a Commercial Drivers License (CDL) holder, you are required to submit a medical report dated within the last two years, every two years. You are required to submit: A valid (original or copy) federal MER MCSA-5875 form. Medical Examiners Certificate Form, (MEC) MCSA-5876.
If the Medical Examiner determines that the driver examined is physically qualified to drive a commercial motor vehicle in ance with the physical qualification standards, the Medical Examiner will complete and provide the driver with a Medical Examiners Certificate (MEC), Form MCSA-5876.
About the Medical Examination Report (MER) Form, MCSA-5875: As part of the physical, drivers are required to fill out the medical history portion of the Medical Examination Report (MER) Form, MCSA-5875.