Information Collection Request

Medical Qualification Requirements

ICR 202112-2126-001 · OMB 2126-0006 · Historical Inactive

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form MCSA-5871 Vision Evaluation Report Form and Instruction New Available
Form MCSA-5871 IC8: Qualification of Drivers: Vision Standard Form and Instruction New Repair queued
Form MCSA-5850 CMV Driver Medical Examination Results Form Form New Repair queued
Form MCSA-5850 IC5b: National Registry of Certified Medical Examiners - CMV Driver Medical Examination Results Form New Repair queued
Form MCSA-5870 Insulin-Treated Diabetes Mellitus Assessment Form Form and Instruction Modified Repair queued
Form MCSA-5870 IC7 -Qualification of Driver; Diabetes Standard Form and Instruction Modified Repair queued
Form MCSA-5876 Medical Examiner's Certificate Revised Form Removed Available
Form MCSA-5875 Medical Examination Report Form Revised Form and Instruction Removed Available
Form MCSA-5875 IC6 - Medical Examiner's Certification Integration Final Rule Form and Instruction Removed Repair queued
Form MCSA-5850 CMV Driver Medical Examination Results Form Form Removed Available
Form MCSA-5850 IC5 - National Registry Certified Medical Examiners Form Removed Repair queued
30-day FR for 2126-0006 10.14.21.pdf Supplementary Document Uploaded 2021-10-14 Repair queued
PRA-2126-0006 SS Vision NPRM final.docx Supporting Statement A Uploaded 2021-12-08 Repair queued
60-day FR for 2126-0006 05.06.21.pdf Supplementary Document Uploaded 2021-09-06 Repair queued
Justification of Non-substantive Changes for MCSA-5875 07.08.20.docx Supplementary Document Uploaded 2020-07-08 Repair queued
PRA-2126-0006 Justification NonSubstantive Change to MCSA-5875 031920.docx Supplementary Document Uploaded 2020-04-22 Repair queued
60-day FR for Insulin-Treated Diabetes Mellitus Assessment Form.pdf Supplementary Document Uploaded 2018-09-18 Repair queued
PRA-2126-0006 Justification NonSubstantive Change 061416.docx Justification for No Material/Nonsubstantive Change Uploaded 2016-07-18 Repair queued
PRA-2126-0006.Justification NonSubstantive Change final 032916.docx Justification for No Material/Nonsubstantive Change Uploaded 2016-03-30 Repair queued
Section4116 of SAFETEA-LU(Public Law 109-59) 081005.doc Supplementary Document Uploaded 2012-04-18 Repair queued
Section 4129 of SAFETEA-LU(PubLaw109-59.doc Supplementary Document Uploaded 2012-04-18 Repair queued
Section 4129 of SAFETEA-LU(PubLaw109-59.doc Supplementary Document Uploaded 2010-01-22 Repair queued
Diabetes Exemption Qualifications of Drivers (70FR67777)110805.pdf Supplementary Document Uploaded 2010-01-22 Repair queued
Diabetes Exemption Applications Qualifications of Drivers (68FR52441)090303.pdf Supplementary Document Uploaded 2010-01-22 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
26039 IC1 - FMCSA Physical Qualification Standards Modified
250713 IC8: Qualification of Drivers: Vision Standard Form and Instruction NewVision Evaluation Report
250713 IC8: Qualification of Drivers: Vision Standard Form and Instruction New
250712 IC5d: National Registry of Certified Medical Examiners - Verification of National Registry Number New
250711 IC5c: National Registry of Certified Medical Examiners - Providing Medical Examination Reports to FMCSA Upon Request New
250710 IC5b: National Registry of Certified Medical Examiners - CMV Driver Medical Examination Results Form NewCMV Driver Medical Examination Results Form
250710 IC5b: National Registry of Certified Medical Examiners - CMV Driver Medical Examination Results Form New
250709 IC5a: National Registry of Certified Medical Examiners - Registering and Testing New
250708 IC3c: Seizure Exemptions New
250707 IC3b - Hearing Exemptions New
233017 IC7 -Qualification of Driver; Diabetes Standard Form and Instruction ModifiedInsulin-Treated Diabetes Mellitus Assessment Form
233017 IC7 -Qualification of Driver; Diabetes Standard Form and Instruction Modified
220813 IC6 - Medical Examiner's Certification Integration Final Rule Form RemovedMedical Examiner's Certificate Revised
220813 IC6 - Medical Examiner's Certification Integration Final Rule Form and Instruction RemovedMedical Examination Report Form Revised
220813 IC6 - Medical Examiner's Certification Integration Final Rule Form and Instruction Removed
216256 IC4 - Skill Performance Evaluation (SPE) Certificate Program Modified
216253 IC3 - Exemptions - Vision, Hearing, Seizure Exemptions Removed
216251 IC2 - Resolution of Medical Conflict Unchanged
201967 IC5 - National Registry Certified Medical Examiners Form RemovedCMV Driver Medical Examination Results Form
201967 IC5 - National Registry Certified Medical Examiners Form Removed

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
12/31/2024 36 Months From Approved 12/31/2024
35,544,723 0 35,544,723
2,707,479 0 2,707,479
0 0 0







Reginfo record details
  No