If you are a commercial driver and do not meet minimum medical standards, you may use a form like this to apply for an intrastate medical waiver. This form must be filled out by you and your medical examiner.
This form is a generic example that may be referred to when preparing such a form for your particular state. It is for illustrative purposes only. Local laws should be consulted to determine any specific requirements for such a form in a particular jurisdiction.
Para su conveniencia, debajo del texto en español le brindamos la versión completa de este formulario en inglés. For your convenience, the complete English version of this form is attached below the Spanish version.