Before your DOT physical / Forms and documents
The right documents depend on your treatment and the examiner’s request. Insulin-treated diabetes, non-insulin-treated diabetes and a requested HbA1c result are separate document needs.
When the insulin-treated diabetes standard applies, ask the clinician who manages and prescribes your insulin to complete MCSA-5870. This is an assessment form, not an insulin waiver.
The medical examiner must receive the completed form and begin your examination no later than 45 calendar days after the treating clinician signs it. Schedule the assessment around your DOT appointment.
Arrange the supporting electronic blood glucose records and laboratory information with your treating clinician. Follow the form’s instructions about the preceding three months of electronic glucose records. Ask the examiner what to bring if those records are incomplete; do not assume that a shorter record history guarantees certification.
Your clinician who manages and prescribes insulin completes this assessment when the insulin-treated diabetes standard applies.
Open Beyond Wellness Insulin-treated diabetes assessment, MCSA-5870 packet (PDF)
FMCSA source and current download
MCSA-5872 is optional. Have your treating clinician complete it only if the medical examiner requests it.
Your treating clinician provides the requested information. Use this optional form only when requested by the medical examiner.
Open Beyond Wellness Non-insulin diabetes assessment, MCSA-5872 (optional) packet (PDF)
FMCSA source and current download
Bring the laboratory report with the result and test date requested by the examiner. Confirm which result or date range is needed before ordering another test. An HbA1c record request is not an additional mandatory federal form for every driver.
These instructions do not set a universal HbA1c cutoff or promise a certification period. The examiner evaluates the applicable standards and your individual circumstances.
Sources checked October 22, 2026: FMCSA MCSA-5870 · FMCSA optional MCSA-5872 · 49 CFR 391.46.
These instructions help you prepare. The certified medical examiner determines which records are needed and whether you meet the applicable standards. Bringing a form does not guarantee certification.