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About the Medical Examination Report (MER) Form, MCSA-5875

HealthRoute Compliance Team

The MER Form (MCSA-5875) is the medical history paperwork you complete as part of your DOT physical. Here’s what it is, why it matters, and how to fill it out to avoid delays.

Commercial driver completing DOT medical history paperwork for the MER Form (MCSA-5875)

The Federal Motor Carrier Safety Administration (FMCSA) requires that interstate commercial motor vehicle (CMV) drivers maintain a current Medical Examiner’s Certificate (MEC), Form MCSA-5876 to drive. During your DOT physical, you’re also required to complete the medical history portion of the Medical Examination Report (MER), Form MCSA-5875.

Why this matters: The MER is where you document your medical history. The examiner uses it (along with your exam results) to determine your certification status and how long your medical card can be issued.

What is the MER Form (MCSA-5875)?

The MER (MCSA-5875) is the official report used during a DOT physical. It includes your medical history and the medical examiner’s findings. Most drivers will spend time completing the health history section before the exam starts.

How the MER connects to your medical card (MCSA-5876)

The MER helps support the decision that leads to the Medical Examiner’s Certificate (MEC):

  • MER (MCSA-5875): medical history + exam documentation
  • MEC (MCSA-5876): the medical card you keep current to operate a CMV

What you’ll be asked to complete

The medical history portion includes questions about conditions that may affect safe driving and DOT compliance. Be prepared to list:

  • Current medications (prescription + over-the-counter)
  • Past diagnoses (blood pressure, diabetes, sleep apnea, heart conditions, etc.)
  • Surgeries or hospitalizations
  • Symptoms (dizziness, fainting, shortness of breath, seizures)
  • Vision or hearing concerns
Pro tip: Bring a current medication list and any supporting documents you already have (CPAP compliance report, A1C results, specialist letters, etc.). It helps your exam move faster.

Common mistakes that cause delays

  1. Leaving blanks: If something doesn’t apply, mark “No” instead of leaving it empty.
  2. Forgetting medications: List them all—especially blood pressure meds.
  3. Not having documentation: Certain conditions may require reports or follow-up paperwork.
  4. Rushing answers: Take your time—accuracy matters.

Download the MER Form (MCSA-5875)

Medical Examination Report (MER) Form — MCSA-5875

You can download the DOT medical form here and fill out the medical history section before your appointment.

Download DOT Medical Form (PDF) → What to expect at your DOT physical

Need help with your DOT physical?

HealthRoute helps drivers and employers stay compliant with clear guidance, fast service, and straightforward next steps. If you’re unsure what paperwork applies to you, we can help you prepare.

Call us at 407-859-1880 or visit us at 4985 Hoffner Ave, Suite 1, Orlando, FL 32812.

The Federal Motor Carrier Safety Administration requires that interstate commercial motor vehicle drivers maintain a current Medical Examiner’s Certificate (MEC), Form MCSA-5876 to drive. As part of the physical, drivers are required to fill out the medical history portion of the Medical Examination Report (MER) Form, MCSA-5875.