Resources & Tools
Patient Resources
Registration Forms
Patient Registration Package
Please fill out these forms before your visit to save time on arrival.
Paquete de registro de pacientes
Complete estos formularios antes de su visita para ahorrar tiempo a su llegada.
DOT Physical Forms
DOT FORM 5875
Medical Examination Report Form shows a driver what to expect during their examination.
This form does not need to be completed before your visit.
DOT FORM 5876
Medical Examiner's Certificate Form is another example of what a driver can expect during the physical exam. Certified drivers will receive their MEC after the exam is completed.
DOT FORM 5870
Insulin-treated Diabetes Mellitus Assessment is for commercial drivers with insulin-treated diabetes. Drivers must have this form completed by their physician no more than 45 days prior to the DOT Physical. This form is required before a Medical Examiner's Certificate Form MCSA-5876 can be issued to a certified driver.
Notice of Privacy Practices
Notice of Privacy Policy
A guide to our patients privacy rights.
Aviso de política de privacidad
Una guía de los derechos privados de nuestros pacientes.