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DOT/CDL Physical Exam Questionnaire

 

 

Things to Know Before your DOT Physical

Welcome

 

- We want to help drivers prepare for their DOT Exams. Things like chronic health conditions, lifestyle habits, prior medical events and tests, and prior DOT physicals are all taken in to

account when certifying for your Medical Examiners Certificate. We are a small clinic and do not have the ability to retrieve medical records or order diagnostic tests. Some drivers need to see their

primary care provider or specialist and request health records or complete forms or received clearance letters from specialists before they come to their exam.

 

We may refer some drivers to:
Occupational Medicine: Skagit Regional Health
3823 172nd Street NE
Arlington, WA 98223
(360) 657-8700.

 

These notes do not encompass all medical situations, so please give us a call if you have any questions about your specific situation before your exam.

 

Primary Care

We highly encourage drivers to have a primary care provider they see regularly, typically at least once per year. Having one helps drivers be aware of their blood pressure, understand any symptoms they have been having, and have a provider they can turn to if needed.

 

We recommend drivers see their primary care provider within 30 days prior to their DOT physical.

- Have your doctor examine your ears and remove any earwax blockages if present

 

Blood pressure

Your blood pressure can change how long a certificate you are given and if it is too high, shorter certificates are issued, or even no certificates if it is very elevated. We recommend checking at least

three times before your exam so you have an idea of what your blood pressure is. Your blood pressure should be under 140 / 90 mmHg

 whether you are on blood pressure medicines or not. It is usually a few points higher when checked here.

 

- Avoid tobacco, any nicotine, caffeine, especially energy drinks for 8 hours prior to the exam

- Take any medications as prescribed by your doctor

- High blood pressure does not typically go away unless something changes i.e. weight loss, lifestyle changes, medications, etc. If you have had high blood pressure before, go see your doctor before you get your DOT physical

 

Sleep Apnea & CPAP

The Federal Motor Carrier Safety Administration (FMCSA) has guidelines regarding evaluating at-risk drivers for sleep apnea. If you have had a sleep study showing no sleep apnea, please print and bring the results to your visit.

 

- For drivers who have not had sleep studies, with a Body Mass Index (BMI)  ≥ 40 mg/kg^2, the FMCSA  requires a sleep study be scheduled after the DOT examination. We cannot complete sleep studies or order them here and therefore, usually refer these drivers elsewhere. Try visiting the below website to enter your height and weight then calculate your BMI.

 

- For drivers with BMI ≥ 33 < 39 the referral decision for a sleep study is based on additional risk factors and symptoms, which will be discussed during your physical.

 

- For drivers WITH sleep apnea who use a CPAP, the driver must bring in their printed CPAP compliance report  for at least the last 90 days, preferably the last year. The FMCSA describes CPAP

compliance as > 4 hrs of use on > 70% of nights

 

- https://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm

Diabetes

 

Drivers with diabetes need to bring a printed version of their hemoglobin A1C test current within 90 days and a form or letter from their provider treating their diabetes. It is very important drivers with

diabetes take their medications as prescribed.

 

- Diabetic drivers not on insulin should have their treating provider complete the Type 2 DM Not on insulin form, or sign a clinic letter with the same information, describing the driver’s diabetes control and bring to their exam

 

- Discuss your A1C with the examiner before you complete the paperwork

 

- Unfortunately we do NOT do DOT physicals for drivers who take insulin

 

DOT Physical Exam Medical Clearance: TYPE 2 DIABETES MELLITUS

 

ADHD

 

- Drivers who take Adderall or Ritalin should have their doctor fill out and sign the attached form template or they can write a letter with the same information on their clinic letterhead.

 

DOT Physical Exam Medical Clearance: ADD/ADHD

 

Heart Attack

 

Drivers with heart disease need to bring a clearance letter or form from their cardiologist. Drivers who have had PCI (stents) need to complete the form or have a clearance letter and bring the results printed of their most recent stress test, completed in the last two years. Drivers who have had CABG, also known as coronary bypass surgery, need to discuss the requirements with the treating provider as the medical documentation requirements are more extensive.

 

DOT Physical Exam Medical Clearance: PERCUTANEOUS CORONARY INTERVENTION

 

Medications

 

You must know what each of the medications you take is, what it is for, how much you take, and when. The link to the Medications Form takes you to a form drivers can have their doctor fill out and then you bring it to your exam. This is helpful if you have several medications or are not sure about the details surrounding them, which we need.

 

CMV DRIVER MEDICATION FORM

 

Again, we want to help you succeed so if you have any questions please just give us a call and we will discuss with you or return your call in 2 business days.  360-435-8262