Form Mcsa 5876 Revised 2024 - 2022 02 25 Revision of a currently approved collection Document pdf Download pdf pdf Form MCSA 5876b OMB No 2126 0006 Expiration Date 11 30 2021 Please note the expiration date on this form relates to the process for renewing the Information Collection Request that includes this form with the Office of Management and Budget
What does this mean to Medical Examiners and Drivers Continue using the forms with the expiration date of August 31st Form MCSA 5875 Form MCSA 5876 until FMCSA publishes new forms DOTPhysicalDOCTORS will update this website when new forms are available INFORMATION UPDATE August 3 2018
Form Mcsa 5876 Revised 2024
Form Mcsa 5876 Revised 2024
Posted December 18, 2021 New versions of the Medical Examiner's Certificate and Medical Examination Report Form have been released by FMCSA. The new versions have an expiration date of 12/31/2024 in the upper-right corner, which was the only change to the forms.
Form MCSA 5876 OMB No 2126 0006 Expiration Date 12 31 2024 Please note the expiration date on this form relates to the process for renewing the Information Collection Request that includes this form with the Ofice of Management and Budget This requirement to collect information as requested on this form does not expire
New DOT Medical Certification Forms MCSA DOT Physical Doctor
Form MCSA 5876 OMB No 2126 0006 Expiration Date 11 30 2021 Medical Examiner s Certificate for Commercial Driver Medical Certification A complete Medical Examination Report Form MCSA 5875 with any attachments embodies my findings completely and correctly and is on file in my office
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The expiration date on the Medical Examination Report Form MCSA 5875 Medical Examiner s Certificate MCSA 5876 and Insulin Treated Diabetes Mellitus Assessment Form MCSA 5870 has been updated to 12 31 2024 and all forms are posted below
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MCSA 5876 Medical Examiner S Certificate Revised OMB 2126 0006
Form MCSA 5876 Expiration Date 03 3112025 OMB No 2126 0006 08 03 2024 The information I have provided regarding this physical examination is true and complete A complete Medical Examination Report Form MCSA 5875 with any attachments embodies my findings completely and correctly and is on file in my office
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The Medical Examiner s Certificate MCSA 5876 and The Insulin Treated Diabetes Mellitus Assessment Form MCSA 5870 Key to remember New DOT medical forms have been approved but examiners may continue to use existing forms for driver physical exams until the new forms are available Driver qualification and hiring 06 30 2023
Earlier this year, the U.S. Equal Employment Opportunity Commission asked that the medical exam form be revised to narrow the scope of medical information requested from drivers. The OMB will likely take that request into consideration as it reviews the form. ... (MCSA-5876), and; The Insulin-Treated Diabetes Mellitus Assessment Form (MCSA-5870).
FMCSA Releases Updated Medical Forms J J Keller
Continue using aforementioned original paper Mobile Examiner s Document Form MCSA 5876 for all qualify drivers including Commercial Learner s Permit Commercial Driver s License applicants holders Continue file paper copies of Medical Examiner s Certificates Form MCSA 5876 to Nation Driver s Licensing Agents
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Form Mcsa 5876 Revised 2024
The Medical Examiner s Certificate MCSA 5876 and The Insulin Treated Diabetes Mellitus Assessment Form MCSA 5870 Key to remember New DOT medical forms have been approved but examiners may continue to use existing forms for driver physical exams until the new forms are available Driver qualification and hiring 06 30 2023
What does this mean to Medical Examiners and Drivers Continue using the forms with the expiration date of August 31st Form MCSA 5875 Form MCSA 5876 until FMCSA publishes new forms DOTPhysicalDOCTORS will update this website when new forms are available INFORMATION UPDATE August 3 2018
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