STACY MEDICAL CENTER
ALAMEDA INDUSTRIAL MEDICAL
DOT / CMV Driver Health
Driver must be able to:
•Bend and stoop
•Maintain couching position to inspect
•Frequent entering and exiting a cab
•Ability to climb ladders
Driver must have:
Perceptual skills to monitor complex driving situation Judgment skills to make quick decisions Manipulative skills to control an oversize steering wheel, shift gears, and maneuver vehicle in crowded areas.
Dishonest responses
•Deliberate omission or falsification of information may invalidate the examination and any certificate issued based on it.
•Subject to civil penalty for making false statement or for concealing a disqualifying condition, 49 USC 521(b)(2)(c)
HIPAA
FMCSA does not prohibit employers from obtaining copies of the form Employers must comply with state and federal laws regarding privacy of employee medical information Authorization is required to release long form.