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For individuals seeking to obtain or renew their Commercial Driver's License (CDL) in Oregon, the scientific rigor of the CDL Medical Examiner’s Certificate comes into play, playing a pivotal role in ensuring driver health and safety. This form, completed exclusively by licensed medical examiners, requires a thorough medical examination in accordance with federal standards designed to evaluate a driver’s physical qualifications for commercial driving duties. Beyond the basic declaration of fitness, it encompasses critical considerations such as the potential need for corrective lenses, specific waivers, and exemptions relevant to various medical conditions. The form also serves as a reminder of the legal implications surrounding fraudulent use, underscoring the importance of honesty in the examination process. It is crucial for medical examiners to not only provide accurate information but also ensure all necessary signatures and details are captured accurately. Drivers, on their part, must understand their responsibilities in submitting this certificate to the Department of Motor Vehicles (DMV) promptly, while also being aware of their options for fulfilling this requirement—whether through mail, fax, or email. Ultimately, this procedure not only aids the DMV in determining eligibility for a CDL but also guarantees that the roads remain safe by confirming that each commercial driver is fit to navigate the demands of large vehicle operation.

Oregon Dot Card For Cdl Example

CDL MEDICAL EXAMINER’S

CERTIFICATE

Completed by Licensed Medical Examiner Only!

Fraudulent use is punishable under applicable

State and Federal laws

(For Oregon Licensed Drivers Only)

MEDICAL EXAMINER’S CERTIFICATE

I certify I have examined __________________________________________________ in accordance with the Federal

Motor Carrier Safety Regulations (49 CFR 391.41-391.49) and with knowledge of the driving duties, I find this person is

qualified; and, if applicable, only when:

 

 

 

Wearing corrective lenses

 

Driving within an exempt intracity zone (49 CFR 391.62)

 

 

 

Wearing hearing aid

 

Accompanied by a Skill Performance Evaluation Certificate (SPE)

 

 

 

Accompanied by a ________ waiver/exemption

 

Qualified by operation of 49 CFR 391.64

 

 

The information I have provided regarding this physical examination is true and complete. A complete examination form with any attachment embodies my findings completely and correctly, and is on file in my office.

SIGNATURE OF MEDICAL EXAMINER

 

 

 

 

 

TELEPHONE

 

 

 

 

DATE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MEDICAL EXAMINER’S NAME (PRINT)

 

 

 

 

 

 

 

 

MD

 

 

 

 

DO

 

 

Chiropractor

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Physician

 

 

Naturopath

 

Advance Practice

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Assistant

 

 

 

 

 

Nurse

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MEDICAL EXAMINER’S LICENSE OR CERTIFICATE NO./ISSUING STATE

 

NATIONAL REGISTRY NO.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SIGNATURE OF DRIVER

INTRASTATE ONLY

CDL

 

 

 

DRIVER’S LICENSE NO.

STATE

 

 

 

 

YES

 

NO

 

YES

 

NO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ADDRESS OF DRIVER

MEDICAL CERTIFICATE EXPIRATION DATE

Notes for Examiner:

Instructions for Medical Examiner:

1.Complete examination in accordance with regulations.

2.Enter all information except signatures and print.

3.Sign the form and either submit to DMV using one of the options below or give it to the patient to submit to DMV.

4.You should also complete a medical examiner's certificate for retention of the driver and motor carrier, as you have in the past.

Instructions for Driver:

After completion by your examiner, submit this entire form to DMV, using one of the options below.

Submission Options:

Mail: DMV Driver Safety

CDL Medical Certification

1905 Lana Ave NE

Salem, OR 97314

Fax: 503.945.5329

E-mail: DSMEC@odot.state.or.us

1.Please ensure you have positively identified the patient by checking the driver license or commercial driver license before conducting the examination and entering the driver’s name, license number and state on the certificate.

2.“Driving within an exempt intracity zone” is not applicable in Oregon.

3.Only a very small number (< 10) of drivers are “qualified by operation of 49 CFR 391.64 in Oregon. If your patient was a participant in this 1990s waiver pilot program, he/she should be able to present documentary evidence of that participation.

4.If the patient is not medically qualified under 49 CFR 391.43, he or she may qualify through issuance of a waiver/ exemption or a skill performance evaluation (SPE). Oregon waivers are valid for intrastate commerce only while FMCSA waivers/exemptions/SPEs are valid for both interstate and intrastate commerce.

a.Waivers or exemptions may be available from FMCSA for vision, diabetic, seizure or hearing conditions. Check “Accompanied by a _____________ waiver/exemption” on the Medical Examiner’s Certificate, filling in the blank with “vision,” “diabetes,” “hearing” or “seizure” and have the patient call 503.399.5775.

b.A Skill Performance Evaluation Certificate may be available from FMCSA for loss/impairment of limbs. Check “Accompanied by a Skill Performance Evaluation Certificate (SPE)” and have the patient call 503.399.5775.

c.An Oregon waiver may be available for vision, insulin dependent diabetes mellitus, limb impairments or amputation, hearing or seizure/seizure disorder. This waiver permits operation of a commercial vehicle in intrastate commerce only. Check “Accompanied by a _____________ waiver/exemption” on the Medical Examiner’s Certificate, filling in the blank with “vision,” “diabetes,” “limb,” “hearing” or “seizure” and have the patient call 503.945.0891.

5.Expiration date may not be more than 2 years after date of examination. If, for instance, the examination was completed on March 15, 2012, the expiration date may be no later than March 15, 2014.

735-7375 (2-13)

Form Characteristics

Fact Name Description
Governing Laws The form complies with the Federal Motor Carrier Safety Regulations (49 CFR 391.41-391.49).
Medical Examiner Requirement Only a licensed medical examiner can complete the CDL Medical Examiner’s Certificate.
Fraud Penalties Fraudulent use of this form is punishable under both state and federal laws.
Examinations The form certifies that the driver has been examined according to federal regulations.
Vision and Hearing Conditions Drivers may qualify for waivers related to vision, diabetes, hearing, and seizure conditions.
Expiration Date The medical certificate cannot expire more than two years after the examination date.
Submission Options Completed forms can be submitted via mail, fax, or email to the DMV.
Identification Requirement Medical examiners must verify the driver's identity before conducting the examination.
Intrastate Zone Note The "exempt intracity zone" condition is not applicable in Oregon.

Guidelines on Utilizing Oregon Dot Card For Cdl

The Oregon Dot Card for CDL form must be completed by a licensed medical examiner. Once filled out, it plays a crucial role in certifying that drivers meet the required medical standards to operate commercial vehicles. Follow the steps below to ensure that the form is completed accurately.

  1. Obtain a copy of the Oregon Dot Card for CDL form.
  2. Ensure you have the driver present for the examination.
  3. Fill in the driver’s full name and driver’s license number at the top of the form.
  4. Conduct the medical examination according to Federal Motor Carrier Safety Regulations.
  5. In the Medical Examiner’s Certificate section, indicate whether the driver is qualified, and note any applicable corrections, such as wearing corrective lenses or having a Skill Performance Evaluation Certificate.
  6. Add the medical examiner’s details, including their name, signature, license number, and contact information.
  7. Record the medical certificate expiration date, ensuring it does not exceed two years from the examination date.
  8. Sign the form and either submit it directly to the DMV or provide it to the driver for submission.

After the medical examiner has completed the form, the driver must ensure that it is submitted to the DMV. This process can be done via mail, fax, or email. It is essential to follow these steps carefully to avoid any delays in processing.

What You Should Know About This Form

What is the Oregon Dot Card for CDL form?

The Oregon Dot Card for CDL form is a Medical Examiner’s Certificate that must be completed by a licensed medical examiner. It verifies that an individual has undergone a physical examination in accordance with federal regulations and is medically qualified to operate a commercial vehicle in Oregon.

Who is eligible to complete the Oregon Dot Card for CDL form?

Only licensed medical examiners are authorized to complete this form. They must have the proper training and credentials to perform the examination and confirm that the driver meets the necessary medical standards.

What does the medical examination involve?

The medical examination assesses a driver's physical capability to safely operate a commercial vehicle. This includes evaluating eyesight, hearing, and overall health to ensure compliance with the Federal Motor Carrier Safety Regulations.

What should I do after my medical examiner completes the form?

After your medical examiner fills out the Oregon Dot Card for CDL form, you are responsible for submitting the entire document to the Oregon Department of Motor Vehicles (DMV). You can mail it, fax it, or email it to the designated DMV office.

What happens if I am not medically qualified?

If you do not meet the medical qualifications outlined by the federal regulations, there may be options available, such as obtaining a waiver or exemption. Once you qualify through one of these methods, you can still operate a commercial vehicle within specific guidelines.

How long is the medical certificate valid?

The medical certificate is valid for up to two years from the date of examination. For instance, if your examination was performed on March 15, 2023, your certificate cannot expire before March 15, 2025.

What types of waivers or exemptions are available?

Waivers and exemptions are available for conditions like vision impairment, diabetes, hearing loss, and seizure disorders. The Oregon waiver allows operation of commercial vehicles only within intrastate commerce. It's important to note that different rules apply for interstate operation.

Can I still drive if I wear corrective lenses or hearing aids?

Yes, you can still drive if you wear corrective lenses or hearing aids, provided you comply with the medical examiner’s findings. The examiner must indicate this on your Medical Examiner’s Certificate.

What does 'qualified by operation of 49 CFR 391.64' mean?

This refers to drivers who participated in a waiver pilot program in the 1990s. If you believe you qualify under this provision, you need to provide documentation of your participation during the examination.

What should I do if I have questions about the form or process?

If you have questions regarding the Oregon Dot Card for CDL form or the medical examination process, you can contact the DMV or your medical examiner directly for guidance. They can provide you with tailored information and further assistance.

Common mistakes

Filling out the Oregon DOT Card for CDL form can be straightforward, but many people make critical mistakes that may delay the certification process. One common error is neglecting to have the form completed by a licensed medical examiner. It's essential that only an approved professional fills out this certificate. If an unlicensed individual fills it out, it could lead to legal penalties.

Another frequent mistake involves incorrect or missing signatures. Both the medical examiner and the driver need to sign the form. Failing to provide these signatures, or signing in the wrong section, complicates submission and processing.

People often misinterpret the regulations regarding the medical certificate expiration date. The expiration date must not exceed two years from the examination date. If the examination occurs on March 15, 2022, the certificate can only be valid until March 15, 2024. Missing this detail can result in the need for a new examination.

Examining documentation is crucial, yet many forget this step. The instructions remind examiners to check the driver's license to ensure accurate information is recorded. Failing to verify identity can result in the wrong details on the medical certificate, creating confusion and delays.

Additionally, applicants sometimes mistakenly mark that they are "driving within an exempt intracity zone.” This option does not apply in Oregon, leading to incorrect certifications. Understanding the specifics of state regulations is vital.

Some individuals attempt to apply for waivers or exemptions without understanding their conditions. If a patient does not meet medical qualifications under federal regulations, checking the appropriate box for "accompanied by a waiver/exemption" becomes necessary. If unclear on what to include in the blank, they should seek guidance.

Another problem arises when examiners do not provide full details on the medical examiner’s certificate. Every section must be filled out completely, including the license or certificate number. Incomplete fields send the form back for correction, prolonging the process.

Some applicants are unaware of the option to retain copies of the medical examiner's certificate. It is advisable for both the driver and the motor carrier to maintain their records for reference. This not only facilitates future compliance but also assists in clarifying issues should they arise later.

Finally, while it might seem minor, failing to submit the entire form to DMV appropriately can lead to delays. Understanding submission options—mail, fax, or email—is crucial. Each method has its requirements and timelines, which can affect the speed at which the processing occurs.

Documents used along the form

When applying for a Commercial Driver's License (CDL) in Oregon, several documents often accompany the Oregon Dot Card For CDL form. Understanding these forms can ensure a smooth licensing process and help you stay compliant with state regulations. Here’s a brief overview of the documents typically required.

  • CDL Medical Examiner’s Certificate: This form is crucial for confirming that the driver has passed a medical examination by a certified medical examiner, ensuring they meet health requirements as set by federal regulations.
  • Proof of Identity: A government-issued photo ID, such as a state ID or passport, is needed. This document proves your identity and is often required to verify that you are who you say you are.
  • Proof of Residency: Documents like utility bills or lease agreements can establish your residency in Oregon. This helps the DMV confirm your address on record.
  • Social Security Number Verification: A Social Security card or other official document that includes your Social Security number is typically required. It confirms your identity and helps track your driving record.
  • Education and Training Certificates: If you’ve completed a truck-driving school or training program, completion certificates may need to be submitted. These documents showcase your skills and training in operating commercial vehicles.
  • Skills Test Certification: After passing the required skills test, this document certifies that you’ve demonstrated the necessary driving skills and knowledge for a CDL. It's a vital component of the licensing process.
  • Payment Receipt: A receipt for any licensing fees paid is important. This document serves as proof of payment and is typically required to complete the application process.

Being prepared with these documents can help facilitate your application for a CDL in Oregon. Each document plays a vital role in ensuring that you meet both the operational and safety requirements necessary for commercial driving.

Similar forms

  • Commercial Driver's License (CDL) Application: Similar to the Oregon Dot Card for CDL form, the CDL application is a formal document required for individuals seeking to obtain a commercial driver's license. Both documents require personal information and must be submitted to the Department of Motor Vehicles (DMV) for processing. The CDL application also serves to verify that the applicant meets all legal requirements to operate commercial vehicles, paralleling the medical qualifications outlined in the Dot Card.

  • Medical Examination Report (MER): The MER serves as a comprehensive medical evaluation for commercial drivers, documenting their physical health to ensure safety on the roads. Like the Oregon Dot Card, the MER is filled out by a licensed medical examiner and must be submitted to the DMV. Both forms detail medical qualifications and can result in conditional licensing based on health status.

  • Driver’s Record of Violation: This document summarizes a driver’s traffic violations and is used by DMVs to assess compliance with state regulations. Similar to the Oregon Dot Card, it emphasizes the importance of maintaining a valid and safe driving record. The implications for CDL holders are significant, as violations can threaten their eligibility to operate commercial vehicles.

  • Skill Performance Evaluation (SPE) Certificate: The SPE Certificate is specifically focused on drivers who may have physical impairments but still want to qualify for a CDL. This document, like the Oregon Dot Card, is crucial for drivers needing special accommodations. Both forms assess physical capabilities and ensure compliance with federal standards for commercial operation.

Dos and Don'ts

Filling out the Oregon DOT Card for CDL (Commercial Driver's License) form requires careful attention to detail. Below is a list of nine things to keep in mind while completing the form, including important dos and don’ts.

  • Do ensure that a licensed medical examiner fills out the form correctly. Only medical professionals listed on the form are authorized to complete it.
  • Double-check all personal information before submission. Verify the driver's name, CDL number, and state.
  • Make sure the medical examiner includes their signature and contact information clearly.
  • Use the correct submission method. Choose between mail, fax, or email as directed on the form.
  • Keep a copy of the completed Medical Examiner’s Certificate for your own records.
  • Don’t forget to check the expiration date. It must not exceed two years from the exam date.
  • Do not leave any blank spaces in the form. Fill in all required information carefully.
  • Do not assume exemptions apply without verification. Review the specific exemptions applicable in Oregon.
  • Avoid submitting the form without first ensuring all signatures are in place. This could delay processing.

By following these guidelines, drivers can ensure a smoother and more efficient review of their CDL medical certification process in Oregon.

Misconceptions

Misunderstandings can create unnecessary confusion, especially when it comes to processes that involve legal and regulatory requirements. Here are five common misconceptions about the Oregon DOT Card for CDL form:

  • Only certain doctors can complete the medical examination. Many believe that any medical professional can fill out this form. In reality, only licensed medical examiners approved by the Federal Motor Carrier Safety Administration (FMCSA) are authorized to complete the examination.
  • All drivers automatically qualify without additional requirements. Some drivers think they automatically qualify to drive after their medical examination. However, qualifications may depend on additional conditions such as corrective lenses, hearing aids, or specific waivers for certain medical conditions.
  • Intrastate driving qualifications are the same as interstate. Many assume that qualifications for intrastate commerce in Oregon are the same as those for interstate driving. This is not true, as Oregon's waivers apply only to intrastate operations, whereas FMCSA waivers cover both types of driving.
  • Once approved, a medical certificate can last indefinitely. It is a common misconception that once a medical examiner’s certificate is issued, it remains valid forever. In reality, the certificate has an expiration date, typically no more than two years from the examination date.
  • There is no need to report medical conditions to the examiner. Some drivers believe providing details about their medical history is optional. Yet, it's crucial to fully disclose any medical conditions, as these directly impact driving qualifications and the overall safety on the road.

Clarifying these misconceptions can enhance understanding of the requirements and processes involved. By being well-informed, drivers can ensure they comply with the necessary regulations and maintain their eligibility to operate commercial vehicles.

Key takeaways

The following are key takeaways regarding the completion and utilization of the Oregon Dot Card for CDL form:

  • The form must be filled out by a licensed medical examiner only.
  • Fraudulent use of the document is punishable under state and federal laws.
  • Medical examiners should certify that the driver meets necessary qualifications under Federal Motor Carrier Safety Regulations.
  • The driver’s name, license number, and state must be accurately entered on the certificate.
  • Drivers with certain medical conditions may qualify through waivers or exemptions issued by the FMCSA or Oregon.
  • Submit the completed form via mail, fax, or email to the DMV.
  • The expiration date of the medical certificate should not exceed two years from the examination date.
  • Only a small percentage of drivers qualify under the special regulation 49 CFR 391.64 in Oregon.
  • Drivers should ensure they have the appropriate supporting documentation if qualifying via a waiver or exemption.