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Click ‘Get Form’ to open the Michigan Medical Waiver in our editor.
Begin by filling out the 'Employer and Driver Information' section. Enter the employer's company name, mailing address, phone number, and USDOT number. Then, provide the driver's name, mailing address, date of birth, and driver's license number.
In the 'Driving Conditions' section, list any disqualifying conditions in order of importance. Specify vehicle information including power unit type and necessary modifications.
Complete the 'Geographic Areas of Operation' by detailing where the driver will operate most frequently. Include maximum daily mileage and types of roads.
Finally, review the 'Agreement and Certification' section. Ensure all parties sign and date the form before submission.
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Information relating to an individuals eligibility for medical certification, requests for exemption from medical requirements, and requests for review ofRead more
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