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CDL Medical-Certification
Connecticut's Online Medical Certification System
Operators who currently have a Commercial Driver’s License (CDL), Class D operators license with a Public Passenger Endorsement and/or US DOT medical card, or operators seeking a Commercial Learner Permit (CLP), are required to submit their medical certificates through this system.
Driver's Privacy Protection Act Warning
The personal information contained within this site is protected by 18 U.S.C. 2721, et seq., (the Driver’s Privacy Protection Act) and Section 14-10 of the Connecticut General Statutes. You are not authorized to access personal information for anyone other than yourself through this web site unless you have specific written permission to do so. Any wrongful or unauthorized access, attempted access, or use of the system or the personal information of others from the system may subject you to criminal prosecution or civil liability.
I am providing this information under penalty of false statement, in accordance with the provisions of 14-110 and 53a-157b of the Connecticut General Statutes. I understand that if I make a statement that I do not believe to be true, with the intent to mislead a public servant in the performance of his or her official function, I will be subject to prosecution under the above-cited laws.
I AGREE to the terms above
Driver Verification
Please enter your information in order to locate your records.
License Number
Date of Birth
To continue the medical registration process, we must verify your email address. Please enter your preferred email address to which you have access and a verification email will be sent to you. Click on the link provided in the email to continue the process.
Contact Email
Confirm Contact Email
Mobile phone for future
TEXT
alerts concerning your Connecticut License
Verify Me
Current CDL Medical Status
Step 2 Of 5
License Number
License Class
Endorsement(s)
Restriction(s)
State Waiver
State Waiver Expiration Date
Federal Exemption
Federal Exemption Expiration Date
Medical Expiration Date
Self Certification Category
Self Certification Date
Medical Examiner’s Certificate
Please enter the information
EXACTLY
as it appears on your Medical Examiner’s Certificate.
If there are no restrictions indicated on your certificate, please check No Restrictions.
The Federal Motor Carrier Safety Regulations (49 CFR 391.41-391.49) and, with the knowledge of the driving duties, I find this person is qualified, and, if applicable, only when (check all that apply)
The Federal Motor Carrier Safety Regulations (49 CFR 391.41-391.49) with any application State variances (which will only be valid for intrastate operations), and, with knowledge of the driving duties, I find this person is qualitied, and, if applicable, only when (check all that apply)
Restrictions
Wearing corrective lenses
Qualified by operation of 49 CFR 391.64 (Federal)
Driving within an exempt intracity zone (49 CFR 391.62) (Federal)
Wearing hearing aid
Grandfathered from state requirements (State)
No Restrictions
Accompanied By
Hearing exemption/waiver
Vision exemption/waiver
Seizure exemption/waiver
Accompanied by a skilled performance evaluation (SPE) certificate (Limb)
National Registry Examiner
First, enter your Medical Examiner's National Registry Number and select the
“Look Up”
button. If the National Registry Number is not found, enter the missing examiner information in the red fields.
National Registry No
Look Up
The information I have provided regarding the physical examination is true and complete. A complete Medical Examination Report Form, MCSA-5875, with any attachment, contains my findings completely and correctly, and is on file in my office.
Examiner First Name
Examiner Last Name
National Registry Number
Physician Type
Issuing State
Medical Examiner Phone Number
Date Certificate Signed
Certificate Expiration Date
Any certification submitted with Qualified by operation of 49 CFR 391.64 (Federal) or Driving within an exempt intracity zone (49 CFR 391.62) (Federal) may only be issued for a maximum of one year from the date of the examination
Examiner State Lic #
Document Upload
Medical Certificate Upload – Click the button below to take an image of your document or browse your files/images to upload your medical forms (Supported file JPEG, PNG, PDF)
Take Image/Browse Files
Preview your PDF
I DO NOT have a waiver/exemption
Waiver/exemption upload- Click the button below to take an image of your document or browse your files/images to upload your medical forms (Supported file JPEG, PNG, PDF)
Take Image/Browse Files
Preview your PDF
Driver Summary
Driver License Number
xxxxx
Date of Birth
xxxxx
Contact Email
xxxxx
Mobile Phone
xxxxx
Medical Examiner Summary
Medical Examiner Name
xxxxx
State License #
xxxxx
Examiner Phone Number
xxxxx
Physician Type
xxxxx
National Registry Number
xxxxx
Issuing State
xxxxx
Date Certificate Signed
xxxxx
Certificate Expiration Date
xxxxx
Medical Form
Waiver Form
I am providing this information under penalty of false statement, in accordance with the provisions of 14-110 and 53a-157b of the Connecticut General Statutes. I understand that if I make a statement that I do not believe to be true, with the intent to mislead a public servant in the performance of his or her official function, I will be subject to prosecution under the above-cited laws.
If you need to submit your self-certification, a link to do so will be provided on your confirmation email.
I AGREE to the terms above
Submit
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CDL Medical-Certification
