DOT Exam Quick Fact Sheet

DOT Physical Exam

STEP 1. Fill out a 1-page brief health history

STEP 2. Complete your DOT physical exam with Dr. R. Scott Rash, DC, RN

- Review of brief medical history (Please all your medications with you or a current print out from your pharmacy)

- If you have Sleep Apnea, you will need to take your SD card to either Smith's Drug or to a place that can print out your CPAP Compliance Report.

- If you have Diabetes, you will need to bring in a copy of your current Hemoglobin A1c lab results. If you don't have one within the past 3 months, then we can perform one in the office on the day of your exam. If we do the Hemoglobin A1c at our office on the day of the exam, you will be responsible for the lab cost separate from the DOT Examination.

- Height, weight, BMI, blood pressure, pulse rate, circulation in all extremities, reflexes, range of motion, respiration, eyes, ears

- Discuss special medical conditions (If you have certain medical conditions, you may have to be referred out for Medical Clearance or

a SPE (Skills Performance Evaluation).

- Urinalysis to check: Blood, Glucose, Protein & Specific Gravity

STEP 3. We complete your paperwork. Photo ID required.

- You get a DOT Medical Certificate to keep with you at all times while you are driving.

- We will scan your Medical Certificate and Medical Examination Report Form into our Electronic Health Record and give you the original forms. We will fax a copy to NC DOT Office and will submit the information to the FMSCA Website for you. If you need, we will also fax the DOT Examination Report to your company.

- Payment is $65.00 and payment options are cash, credit card or pre-authorized company account.

DOT Drug Alcohol Testing

Drug alcohol testing is not part of a DOT physical exam but your Company may request to have drug alcohol testing done at the same time.

DOT drug testing and blood alcohol testing are separate tests and separate charges.

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Breakthrough Chiropractic Clinic, PA


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