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Driver Examination Forms

The Rural Health Clinic has Medical Examiners certified to perform driver medical examinations required by the Federal Motor Carrier Administration. The driver should bring all medications and any relevant medical records to the appointment. Please call the clinic if you have questions about what is needed.
The final version of the newly revised driver examination form has been posted in the Resource Center of the National Registry website and is accessible by clicking on the link below.

Medical Examination Report (MER) Form, MCSA-5875

The driver must complete page 1 and 2. You can fill it out and print prior to your appointment.

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