University Health Center
MyUHC Your Visit Patient Services Wellness & Advocacy Insurance & Billing About Us
MyUHC Your Visit
Hours and Location Appointments Emergency Patient Forms Patient Rights and Responsibilities Notice of Privacy Practices Drug Facilitated Sexual Assault (DFSA) Information
Patient Services
Medical Services Faculty Staff Assistance Program Occupational Health Psychiatry and Substance Use Services (PASS) Substance Use Intervention & Treatment (SUIT) Clinics
Wellness & Advocacy
CARE to Stop Violence Health Promotion & Wellness Services
Insurance & Billing
Mandatory Insurance and Waiver Billing and Costs Insurance and Billing Contacts Insurance Filing Mandatory Insurance FAQ
About Us
Meet Our Team Mission and Values Who Can Use Our Services Campus Communications Patient Feedback Student Involvement Contact Us
Hours and Location Appointments Emergency Patient Forms Patient Rights and Responsibilities Notice of Privacy Practices Drug Facilitated Sexual Assault (DFSA) Information
Medical Services Faculty Staff Assistance Program Occupational Health Psychiatry and Substance Use Services (PASS) Substance Use Intervention & Treatment (SUIT) Clinics
CARE to Stop Violence Health Promotion & Wellness Services
Mandatory Insurance and Waiver Billing and Costs Insurance and Billing Contacts Insurance Filing Mandatory Insurance FAQ
Meet Our Team Mission and Values Who Can Use Our Services Campus Communications Patient Feedback Student Involvement Contact Us

DOT Physicals
Home DOT Physicals

Please call 301.405.3153 or 301.314.8184 to schedule your DOT appointment.

You will need to schedule a separate appointment with the lab for a urine test. If this is your first DOT physical for Shuttle-UM, you will need to schedule an additional appointment for drug testing.

Prior to your appointment with the provider, update your “Health History” in the Patient Portal. In addition, complete and sign section 1 of the DOT Medical Examination Report Form:

Required for Section 1 of DOT Form

DRIVER INFORMATION

  • Personal Information (page 1)
  • Driver Health History (pages 1-2)
  • CMV Driver's Signature (page 2)

WHEN YOU ARRIVE FOR YOUR APPOINTMENT, PLEASE BRING THE FOLLOWING ITEMS:

  • Completed DOT Medical Examination Report Form (pages 1-2)
  • Driver’s License
  • Drivers with vision problems must bring their eyeglasses or contacts
  • Drivers with hearing problems must bring their hearing aids

Drivers with psychological disorders (i.e. ADHD, depression, bipolar disorder, etc.) must bring a completed CMV Driver Medication Form from their mental health professional (psychiatrist or psychologist)

DRIVERS WITH DIABETES MUST BRING THE FOLLOWING:

  • A copy of their most recent blood test results that includes their Hemoglobin A1C (HgA1C) level (within the last 3 months).
  • Drivers that require insulin to treat their diabetes must also bring The Insulin-Treated Diabetes Mellitus Assessment Form that has been completed by their treating clinician within forty-five (45) days of your DOT appointment. In addition, these drivers must also bring records of their preceding three (3) months of ongoing blood sugar logs.

DOT Forms
University Health Center
University Health Center, Building #140
health@umd.edu 1-301-314-8184