Insulin-Treated Diabetes Mellitus Assessment Form, MCSA-5870

As a part of the medical certification process for insulin treated diabetes mellitus (ITDM) individuals, the Federal Motor Carrier Safety Administration requires that the Insulin Treated Diabetes Mellitus Assessment Form (ITDM), MCSA-5870, be completed by the ITDM individual’s Treating Clinician attesting that the individual has a stable insulin regimen and properly controlled diabetes. ITDM individuals are required to provide the ITDM Assessment Form, MCSA-5870, to the Certified Medical Examiner within 45 days of completion by the Treating Clinician.

You can download this form at --->> https://www.fmcsa.dot.gov/regulations/medical/insulin-treated-diabetes-mellitus-assessment-form-mcsa-5870 

 

CALL PREVENTIVEPLUS TODAY IF YOU HAVE ANY QUESTIONS REGARDING DOT REGULATIONS (201) 444-3060 One West Ridgewood Ave. Paramus, NJ 07652

Source - www.fmcsa.dot.gov 

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PreventivePLUS Recognized Leader in Workplace Health Management

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