When someone is seeking to obtain or renew a commercial driver’s license (CDL) a DOT (Department of Transportation) Physical Form is the document used to assess their physical fitness. This document is mandated by the U.S. Department of Transportation (DOT). It is an essential requirement for CDL applicants to ensure they meet the necessary health standards to operate commercial vehicles safely. The form includes personal information, a comprehensive medical history section, and results from a physical examination performed by a licensed medical examiner who signs off on the driver’s physical ability to do their job. The DOT Physical form template is available in Word, PDF, and Google Docs for your convenience.
About DOT Physical Form
A DOT Physical Form plays a crucial role in encouraging and facilitating road safety. By evaluating the health of commercial drivers, the DOT and employers can ensure the person behind the wheel meets the minimum physical requirements for the job. Here are the key elements typically found in a professionally designed DOT Physical Form:
Form Title: The top clearly states “DOT Physical Form” to prevent confusion and streamline recordkeeping efforts.
Personal Information: This section collects the driver’s name, contact information, identification details, and CDL-related information.
Medical History Questions Chart: This area asks basic health questions in a chart or checklist style.
- Condition: Lists various medical conditions and health-related questions.
- Yes, No: Requires a Yes or No response to each question, indicating the presence or absence of specific medical conditions.
Physical Examination Chart:
- Physical System: This shows which different body systems need to be examined during the evaluation.
- Normal: This indicates whether each system showed normal findings during the physical examination.
- Abnormal: Here, the physician notes any abnormal or concerning findings discovered during the examination.
- Comments: A licensed medical examiner can provide comments or recommendations based on their assessment in this area.
A licensed medical examiner is required to complete the DOT Physical Form. They are personally responsible for conducting a thorough physical examination and reviewing the individual’s medical history for accuracy and any areas of concern. Their evaluation determines if the applicant meets the DOT’s medical qualifications for operating commercial vehicles safely. In short, the licensed medical examiner is the only person who can or should fill out this document, though anyone can create one and issue it to drivers for completion.
A personal physician cannot generally conduct the physical examination for the DOT Physical Form. The examination must be performed by a licensed medical examiner who is certified and listed on the National Registry of Certified Medical Examiners (NRCME) by the Federal Motor Carrier Safety Administration (FMCSA). If your physician has these qualifications, they can fill out the DOT Physical Form.
In the medical history section of the DOT Physical Form, drivers must provide accurate details about any past surgeries they have undergone. Include the type of surgery, the date of the procedure, the name of the surgeon or medical facility, and any relevant post-surgery information, like recovery status. Failure to do this can result in loss of job or license in many cases.
The acceptance of digital signatures on the DOT Physical Form varies depending on state regulations and the preferences of the medical examiner. Some states and examiners accept digital signatures, while others require a physical signature. It is essential for applicants to confirm the specific requirements with the medical examiner before the examination. However, it is worth noting that accepting digital signatures is becoming more commonplace.