Updated Info Regarding FMCSA's Changes to the MCSA-5875 Form

The changes include:

  1. The removal of the request for gender
  2. Corrections to punctuation and grammar
  3. Minor formatting changes to correct errors and promote consistency in the style of bullet points, quotation and apostrophe marks, use of bolding and italics, and use of a forward slash instead of a comma. 

"MEs that have purchased these forms in bulk, or require time to reprogram electronic system forms, MAY CONTINUE TO USE THE OLD FORMS until stocks have been depleted or forms have been reprogrammed but should transition to use of the new forms as quickly as possible. However, based on the Technical Amendment, after September 5, 2021, instructions should be provided to the driver that they should leave the gender question blank on the Medical Examination Report Form, MCSA-5875."


The current forms posted on the FMCSA website are scheduled to expire on November 30, 2021. However, FMCSA is in the process of submitting the renewal request information for approval from OMB. MEs should continue to use the forms that are currently posted on the FMCSA website until the renewal request has been approved. Upon approval, new versions of the Medical Examination Report Form, MCSA-5875, Medical Examiner's Certificate, MCSA-5876, and Insulin-Treated Diabetes Mellitus Assessment Form, MCSA-5870, will be posted on the FMCSA website.

Confusing or Misleading Solicitations from Third-Party Administrators

"FMCSA is aware that entities are receiving confusing or misleading solicitations from service providers or third-party administrators by telephone, e-mail, text and US Mail.

The U.S. Government does not endorse private businesses or vendors and the use of a service provider is NOT required by FMCSA."
There are two ways you can access the MCSA forms from the TeamCME website:

  • Scroll to the bottom of almost any page to find the link under the "CDL Physicals" column
  • Or, login to the TeamCME Member Center, click on Member Resources, and click on the top link within the FMCSA tab.
Nationwide Network of DOT Medical Examiners
509 SW Frazer Ave.
Pendleton, OR 97801
Phone: (541) 276-6032
Fax: (541) 276-7062
Hours of Operation:
Monday-Thursday 8am to 5pm
Friday 8am to 12pm