Federal Register - July 7, 2021
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Source: Federal Register
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Federal Register / Vol. 86, No. 127 / Wednesday, July 7, 2021 / Rules and Regulations 0 Meetntandards, but petfodic monitoring Is required: Selectthis option when a driver is determined to be qualified but needs periodic monitoring and provide an explanation ofwhy periodic monitoring is required. Select the corresponding time frame that the driver is qualified for, and if 0 Determination that driver meets standards: Select all categoriE!$ that apply to the drivers certification e.g., wearing corrective lenses, accompanied by a waiver/exemption,etc.. Medkal Examiner Information, signature and date:Provide your name, address, phone number, occupation, license,.cettificate, or registration number and issuing state,. national registry number, signature.and date. II. If updating an existing exam, you must resubmftthe new exam results, via the.Medical Examination Resu Its Form, MCSA-5850, to the National Registry, and the most recent dated exam wlll take precedence. m. To obtain additional Information regarding this form goto the Medical Programs page on the Federal Motor carrier Safety Af,lmlnistratlonswebstte at tittp:llwww.fmCSA,dot,90v/r19g1atJonstmedkal 15:58 Jul 06, 2021 Jkt 253001 PO 00000 Frm 00058 Fmt 4700 Sfmt 4725 E:FRFM07JYR1.SGM 07JYR1 ER07JY21.085 khammond on DSKJM1Z7X2PROD with RULES Page9
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selecting "other" specify the time frame.
0
Medical Examiners Certificate Expiration Date: Enter the date the drivers 1lledlcal Examiners
Certificate MEC expires;
VerDate Sep<11>2014
