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Medical Examination Report FOR COMMERCIAL DRIVER FITNESS DETERMINATION 649-F 6045 1. DRIVER S INFORMATION Driver completes this section Driver s Name Last First Middle Social Security No. Birthdate M/D/Y Address City State Zip Code Work Tel Age New Certification Sex M Recertification F Follow-up Driver License No. License Class State of Issue C D A B Home Tel 2. HEALTH HISTORY Date of Exam Other Yes No Any illness or injury in the last 5 years Head/Brain injuries disorders or illnesses...
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How to fill out printable dot physical forms

How to fill out dot physical form:
01
Ensure you have all necessary personal information, including your name, date of birth, address, and contact information.
02
Answer the medical history questions accurately and truthfully, providing details on any previous medical conditions, surgeries, or medications taken.
03
Undergo a thorough physical examination conducted by a certified medical examiner, including measurements of height, weight, blood pressure, and vision tests.
04
Complete all required sections of the form, such as the driver's information, certifications, and attestations.
05
Sign and date the form, verifying that all the information provided is accurate and true.
Who needs dot physical form:
01
Commercial drivers who operate vehicles that require a CDL (Commercial Driver's License) are typically required to undergo a DOT (Department of Transportation) physical and fill out the corresponding form.
02
This includes individuals driving large trucks, buses, or vehicles that transport hazardous materials.
03
It may also be required for individuals seeking employment as commercial drivers or those who need to renew their commercial driver's license.
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