Additional items by condition
Diabetes
- Hemoglobin A1c (HbA1c) lab results — within the past 6 months
- Latest blood glucose logs or CGM reports
- Insulin-Treated Diabetes Mellitus assessment form (ITDM, MCSA-5870) — completed by your treating clinician if you use insulin
Sleep apnea
- CPAP/BiPAP compliance data — report showing ≥4 hours use on ≥70% of nights over the past 90 days
Cardiovascular conditions
- Cardiologist clearance letter — within 30–60 days, confirming stability
- Recent EKG, stress test, or echocardiogram reports as required by your condition
- Cardiac medication list — including anticoagulants (with recent INR if on warfarin)
Vision or hearing exemptions
- Federal vision exemption certificate, if you have a vision waiver
- Skill Performance Evaluation (SPE) certificate for limb impairments
- Hearing waiver documentation, if applicable
Other common conditions
- Seizure disorder: neurologist letter confirming seizure-free period, plus EEG if recent
- Psychiatric conditions: letter stating the condition is stable and medications do not impair driving
- Respiratory (COPD, oxygen): pulmonologist letter, recent PFTs, oxygen prescription if used
- Substance use history: SAP return-to-duty letter and negative drug screen if applicable
Final checklist
- Call the clinic 24 hours ahead if any requirement is unclear
- Bring original documents
- Plan for about 30 minutes; complex conditions may take longer
- Arrive hydrated — a urinalysis is part of the exam
- Wear loose clothing for blood pressure, vision, and hearing checks
Important: Failure to bring required documentation will result in an incomplete exam and you will need to reschedule. Information is based on FMCSA guidelines as of 2025. Always verify with your certified medical examiner.