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How do I fill this out?
Filling out this form requires you to determine the correct certification category that applies to you. You will need to provide personal information and a valid signature. Ensure that all information is accurate to avoid penalties.

How to fill out the CDL Medical Self Certification Requirements Guide?
1
Read the certification categories carefully.
2
Select the category that applies to your driving.
3
Fill in your personal information.
4
Sign and date the form appropriately.
5
Submit the completed form using the specified method.
Who needs the CDL Medical Self Certification Requirements Guide?
1
Commercial drivers who operate CMVs.
2
Individuals upgrading their CDL.
3
Drivers transferring a CDL from another state.
4
Those renewing their CDL.
5
Drivers with changes in their medical status.
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What are the instructions for submitting this form?
You can submit this form in several ways: Fax it to (801) 957-8633, email it to dlmedcert@utah.gov, or mail it to CDL Med Cert, PO BOX 144501 -SLC, UT 84114-4501. Ensure that you choose the method that is most convenient for you and provide accurate information to avoid delays.
What are the important dates for this form in 2024 and 2025?
Key dates for this form include: initial issuance, upgrade, and renewal deadlines each year, as dictated by DMV regulations. Ensure timely submission to maintain your CDL status.

What is the purpose of this form?
The purpose of this form is to ensure that all commercial drivers are medically fit to operate their vehicles. It is a regulatory requirement that aids in maintaining road safety. Completing this certificate helps fulfill state and federal laws.

Tell me about this form and its components and fields line-by-line.

- 1. Name: Your full name as it appears on your identification.
- 2. Date of Birth: Your birth date for identification purposes.
- 3. DL#: Your Driver's License number.
- 4. Signature: Your signature to certify the information provided.
- 5. Certify Date: The date on which you are signing the form.
What happens if I fail to submit this form?
Failing to submit this form can lead to legal and administrative penalties, including disqualification from operating a commercial vehicle. You may face difficulty in renewing or upgrading your CDL status.
- Legal Penalties: Failure to comply with medical certification can result in legal consequences.
- CDL Disqualification: Not submitting the form may lead to disqualification of your CDL.
- Operational Limitations: Without the necessary certification, you may be restricted from driving commercial vehicles.
How do I know when to use this form?

- 1. Initial Application: To certify medical fitness when applying for a CDL for the first time.
- 2. License Upgrade: To certify fitness when upgrading an existing CDL.
- 3. License Renewal: To reaffirm your medical fitness during the renewal process.
- 4. Transfer from Another State: To ensure compliance when transferring your CDL to Utah.
- 5. Change in Medical Status: To report and certify any changes in your medical condition.
Frequently Asked Questions
What is this form for?
This form is for CDL holders to certify their medical fitness to operate commercial vehicles.
Who must complete this form?
All CDL holders and applicants in Utah need to fill out this form.
How do I submit the form?
The form can be submitted via fax, email, or postal mail.
Can I edit the form online?
Yes, you can edit the PDF using PrintFriendly's editing tools.
How do I sign the PDF?
You can add your signature directly on PrintFriendly.
Is there a deadline for submitting this form?
It should be submitted upon initial issuance, upgrade, renewal, or transfer of your CDL.
What if I provide false information?
Providing false information can lead to penalties including disqualification of your CDL.
Can I share this form with others?
Yes, sharing is easy through PrintFriendly's features.
What information do I need to provide?
You need to provide your personal details, driving history, and certification selection.
Who can help me if I have questions about the form?
Contact the Driver License Division for assistance.
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