DOT MEDICAL FORMS & CERTIFICATES

Driver Medical Examination Forms by State/Region

Tri-State Area & Pennsylvania

You are required to fax your medical certification to: FAX: (860) 263-5568

MAIL TO: NJ Motor Vehicle Commission Driver Review Bus Application Unit PO Box 127 Trenton, NJ 08666.  For further assistance, contact the MVC Bus Application Unit by phone at (609) 292-7500 ext. 5039.

 Please mail the Self-Certification form and medical certificate (if applicable) to: Bureau of Driver Licensing • P.O.Box 69008 • Harrisburg, PA 17106-9008

Mid-Atlantic

Option #1 - Email address: cdlmedcert@mva.maryland.gov (scanned copies only)
Option #2 - FAX: 410-787-7959
Option #3 - For mail or in-person deliveries:

Maryland MVA
6601 Ritchie Highway, N.E.
Room 145, Attn: CDL Med Cert
Glen Burnie, MD 21062
 

Northeast

Mail forms to: MassDOT, RMV Division, Driver Licensing PO Box 55889 Boston, MA 02205 Submit forms in person to: Any RMV branch office. Locations can be found by visiting http://www.massrmv.com

Mail in: NH-DMV DRIVER LICENSING BUREAU 23 HAZEN DRIVE CONCORD, NH 03305 E-mail the new form filled out and a scanned copy of the DRIVER LICENSE and MEDICAL CARD in PDF form: NHCDLMEDCARDS@dos.nh.gov

STATE OF RHODE ISLAND AND PROVIDENCE PLANTATIONS DIVISION OF MOTOR VEHICLES COMMERCIAL DRIVER’S LICENSE OFFICE 600 New London Avenue Cranston, RI 02920-3024 Phone: 401-462-4368 http://www.dmv.ri.gov

Southeast

Email to: CDLmedical@ncdot.gov; Fax number is (919) 861-3915; Phone number is (919) 861-3599; Address: NCDMV CDL Medical Certification Unit 3126 Mail Service Center Raleigh, NC 27699-3126; website http://www.ncdot.gov/dmv

Mail this form and copies of medical documents to: SCDMV – CDL Help Desk PO Box 1498 Blythewood, SC 29016-0028 ; Scan the documents and then email them to: CDLHelpDesk@scdmv.net;  Fax this form and medical documents to the CDL Help Desk. Fax number is (803) 896-2676;   A list of office locations and hours can be found on our websitewww.scdmvonline.com Please contact the CDL Help Desk at (803) 896-2673 if you have any questions regarding this form.

The Self Certification Affidavit and medical certificate, may be submitted to the state at any Arkansas Revenue Office (http://www.dfa.arkansas.gov/Pages/revenueOffices.aspx) or may be mailed or faxed to: Safety Responsibility Ragland Building, Room 1120 P.O. Box 1272 Little Rock, AR 72203 Fax: (501) 682-2100 ; Phone 501-682-7100.

Mail to:  WV DMV PO Box 17010 Charleston, WV 25317

Tennessee Department of Safety and Homeland Security Commercial Driver License Division 1148 Foster Avenue Nashville, TN 37243.   Fax this self-certification along with your medical examiner’s certificate to: 615-401-7674 or by email the scanned copies in a PDF format to: DI.CDL.Medcert@tn.gov In the Tel. 615-687-2312.

Self-certifications and medical certifications can be submitted in the following ways: To any Louisiana Office of Motor Vehicles location By fax 225-925-3901 By email at OMV_CDL_Medical@dps.la.gov

Mail:  Division of Driver Licensing, 200 Mero Street, Frankfort, KY 40622 or fax to 502-564-3250 or scan and email to KYTC.CDL@ky.gov

Midwest

Mail to:  Illinois Secretary of State c/o CDL Medical Unit 2701 S. Dirksen Parkway Springfield, IL 62723 or by emailing a copy of the certificate to: cdlmedicalcard@ilsos.net.

Mailing the certificate to: Iowa Department of Transportation Office of Driver Services P.O. Box 9204 Des Moines, IA 50306-9204. Faxing the certificate to the Office of Driver Services at: 515-239-1837. Emailing a scanned copy of the certificate to the Iowa DOT at CDLMedCert@dot.iowa.gov. (email submissions must be scanned and attached as a .pdf file). 

Mail to:  MINNESOTA DEPARTMENT OF PUBLIC SAFETY DRIVER AND VEHICLE SERVICES 445 Minnesota Street Saint Paul, MN 55101-5175 Phone: (651) 297-5029 Web: dvs.dps.mn.gov

Fill out your Medical Self Certification form and include a copy of your DOT physical card. You can mail or fax this information to:

Driver Licensing
Docking State Office Building
Attn: Medical Cert
P.O. Box 2188
Topeka, KS 66601-2128
Fax: 785-296-5859

Nebraska Department of Motor Vehicles
Driver and Vehicle Records Division
301 Centennial Mall South
P.O. Box 94789
Lincoln, NE 68509-4789

Phone # (402) 471-3918
Fax # (402) 471-8694

Mail, fax, or email to: Drivers License Division 608 East Boulevard Avenue Bismarck, ND 58505-0750 or Fax to 701-328-0308 or Email with a PDF attachment to dotfaxdlmedicalcerts@nd.go

Southwest & West

Turn in the form at your nearest driver license office; Fax them to 801-957-8633; E-mail dlmedcert@utah,gov; or Mail a COPY (do not send the originals) to the Driver License Division a Utah Driver License Division ATTN: Med-Cert Desk PO BOX 144501 Salt Lake City UT 84114-4501

Department of Motor Vehicles
CDL Unit, G204
P.O. Box 944278
Sacramento, CA 94244-2780

Mail: PO Box 2100, Mail drop 818Z Phoenix, AZ 85007
Fax: 602.239.6288
Email: MedicalReview@azdot.gov
Questions: Please call 602.771.2460

Please mail, fax, or email the medical certificate (if applicable) and the Self-Certification affidavit to: Oklahoma Department of Public Safety CDL Administration PO Box 11415 Oklahoma City, OK 73136-0415 mec@dps.state.ok.us Fax to 405-419-2196

This completed form can be faxed to 303-205-5709 Attn: CDL Unit or mailed to: Colorado Department of Revenue ATTN: CDL Unit Room 154 1881 Pierce St. Lakewood CO 80214

Visiting a CDL/CLP office

Email:CDLMED@dol.wa.gov

Fax: 360.570.4915

Mail
CDL Medical Unit
Department of Licensing
PO Box 9030
Olympia, WA 98507-9030