Content Overview
The Oregon DOT Card for CDL form is an essential document for individuals seeking to obtain or maintain their Commercial Driver's License (CDL) in the state of Oregon. This form serves as a Medical Examiner's Certificate, which must be completed by a licensed medical examiner who is qualified to assess the driver's medical fitness. The examination must adhere to the Federal Motor Carrier Safety Regulations, ensuring that the driver meets the necessary health standards for safe operation of commercial vehicles. The form includes important details such as the driver's name, CDL number, and medical examiner's information, along with the findings of the medical examination. It also outlines specific conditions under which a driver may qualify, such as wearing corrective lenses or having a Skill Performance Evaluation Certificate. Furthermore, the form provides instructions for both the medical examiner and the driver regarding submission options, emphasizing the importance of accuracy and compliance with state and federal laws. This document is vital not only for regulatory purposes but also for the safety of all road users, as it ensures that only medically fit individuals are operating commercial vehicles.
Similar forms
The Oregon Dot Card for CDL form is an essential document for commercial drivers, particularly regarding their medical qualifications. Several other documents share similarities with this form, particularly in terms of purpose, structure, and the information they require. Here’s a look at nine such documents:
- DOT Medical Examination Report: Like the Oregon Dot Card, this report is completed by a licensed medical examiner and assesses a driver's medical fitness to operate a commercial vehicle. It includes similar sections regarding qualifications and medical history.
- FMCSA Medical Certificate: This certificate, issued by the Federal Motor Carrier Safety Administration, serves a similar purpose in certifying that a driver meets federal health standards. It requires a medical examiner's signature, just like the Oregon form.
- Commercial Driver's License Application: This application requires drivers to disclose their medical history and provide proof of medical examination, linking it closely to the requirements of the Oregon Dot Card.
- Skill Performance Evaluation (SPE) Certificate: This document is used for drivers who have specific physical impairments but still meet safety standards. It parallels the Oregon Dot Card in that both address exceptions to standard medical qualifications.
- Intrastate Waiver Application: This application is similar in that it allows drivers with certain medical conditions to operate within state lines. It involves a review process akin to that of the Oregon Dot Card.
- Vision Waiver Application: Similar to the Oregon Dot Card, this document allows drivers with vision impairments to qualify for a CDL under specific conditions, ensuring safety while accommodating their needs.
- Diabetes Waiver Application: This application is focused on individuals with diabetes, allowing them to demonstrate their ability to drive safely, much like the exemptions noted in the Oregon Dot Card.
- Non-disclosure Agreement (NDA) - A key document that safeguards sensitive information, the NDA ensures confidentiality similar to the protections offered by the Oregon DOT Card for CDL. For those seeking templates or guidance on drafting an NDA, resources such as Forms Georgia can be invaluable.
- Hearing Waiver Application: This document parallels the Oregon Dot Card by providing a pathway for drivers with hearing impairments to obtain a CDL, ensuring they meet safety standards.
- Seizure Disorder Waiver Application: Like the Oregon Dot Card, this application is designed for drivers with seizure disorders to demonstrate their medical fitness, ensuring they can operate commercial vehicles safely.
Each of these documents plays a crucial role in ensuring that commercial drivers meet the necessary health and safety standards, thereby protecting both the drivers and the public.
Preview - Oregon Dot Card For Cdl Form
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
qualified; and, if applicable, only when: |
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Wearing corrective lenses |
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Driving within an exempt intracity zone (49 CFR 391.62) |
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Wearing hearing aid |
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Accompanied by a Skill Performance Evaluation Certificate (SPE) |
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Accompanied by a ________ waiver/exemption |
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Qualified by operation of 49 CFR 391.64 |
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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 |
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TELEPHONE |
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DATE |
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MEDICAL EXAMINER’S NAME (PRINT) |
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MD |
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DO |
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Chiropractor |
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Physician |
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Advance Practice |
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Assistant |
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Nurse |
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MEDICAL EXAMINER’S LICENSE OR CERTIFICATE NO./ISSUING STATE |
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NATIONAL REGISTRY NO. |
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SIGNATURE OF DRIVER |
INTRASTATE ONLY |
CDL |
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DRIVER’S LICENSE NO. |
STATE |
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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
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.
Key takeaways
Filling out the Oregon Dot Card for CDL form can seem daunting, but understanding its components and requirements can make the process smoother. Here are some key takeaways to keep in mind:
- Medical Examination Requirement: A licensed medical examiner must complete the medical examiner’s certificate, ensuring that the driver meets health standards.
- Fraud Prevention: Fraudulent use of the form is illegal and can result in penalties under state and federal laws.
- Examination Regulations: The examination must comply with Federal Motor Carrier Safety Regulations, specifically sections 49 CFR 391.41-391.49.
- Driver Identification: The medical examiner must verify the driver's identity by checking their driver’s license or CDL before completing the form.
- Submission Options: Once completed, drivers can submit the form via mail, fax, or email to the DMV.
- Waivers and Exemptions: If a driver does not meet medical standards, they may qualify for a waiver or exemption, but these are typically limited to specific conditions.
- Expiration Dates: The medical certificate cannot have an expiration date more than two years from the examination date.
- Skill Performance Evaluation: In some cases, a Skill Performance Evaluation Certificate may be necessary for drivers with certain impairments.
- Driver's Responsibility: After the medical examination, it is the driver's responsibility to ensure the form is submitted correctly to the DMV.
- Specific State Regulations: Be aware that some regulations, such as “driving within an exempt intracity zone,” do not apply in Oregon.
Understanding these key points can help ensure that the process of filling out and using the Oregon Dot Card for CDL form is efficient and compliant with regulations.
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Oregon Statement - For any updates or corrections, refer to the Oregon Department of Revenue guidelines.
File Details
| Fact Name | Details |
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| Purpose of the Form | The Oregon Dot Card for CDL form is used to certify that a driver has passed a medical examination as required by federal regulations. |
| Governing Laws | This form is governed by the Federal Motor Carrier Safety Regulations, specifically 49 CFR 391.41-391.49. |
| Medical Examiner's Role | A licensed medical examiner must complete the form, ensuring that the information provided is accurate and complete. |
| Submission Options | Drivers can submit the completed form to the DMV via mail, fax, or email, as specified in the instructions. |
| Expiration of Medical Certificate | The medical certificate must not expire more than two years after the examination date. |
Documents used along the form
The Oregon Department of Transportation (DOT) Card for Commercial Driver’s License (CDL) is an essential document for drivers seeking to operate commercial vehicles in Oregon. Alongside this form, several other documents are commonly required to ensure compliance with state and federal regulations. Below is a list of related forms and documents that may accompany the Oregon DOT Card for CDL.
- CDL Application Form: This form is necessary for individuals applying for a commercial driver's license. It collects personal information, driving history, and medical history to assess eligibility.
- CDL Skills Test Score Sheet: After passing the required skills tests, this sheet documents the results. It is crucial for verifying that the applicant has demonstrated the necessary driving skills.
- Medical Examination Report (MER): This report is filled out by the medical examiner during the physical examination. It provides detailed findings about the driver’s health and fitness to operate a commercial vehicle.
- Vision Test Report: A separate report that confirms the driver's vision meets the standards set by the state. This document may be required if the medical examiner notes any vision concerns.
- Articles of Incorporation: Required for businesses to legally establish themselves; details can be found at https://legalformspdf.com.
- Skill Performance Evaluation Certificate (SPE): This certificate is issued to drivers who have certain physical limitations but can still operate a commercial vehicle safely. It serves as evidence of their qualifications despite those limitations.
- Waiver/Exemption Forms: These forms may be necessary for drivers who do not meet standard medical requirements but have received specific waivers or exemptions from the Federal Motor Carrier Safety Administration (FMCSA).
- Proof of Identity and Residency: A document such as a state-issued ID or utility bill may be required to establish the applicant's identity and residency within Oregon.
Each of these documents plays a critical role in the process of obtaining and maintaining a CDL in Oregon. Ensuring that all necessary forms are completed accurately and submitted on time is essential for compliance and the safe operation of commercial vehicles.