DOT Physicals Request

Limit 5 Appointments Daily

Things to remember to bring with you:

Valid ID card

Sleep Apnea – CPAP print out from the last 90 days.                You will need to have used your CPAP for at least 30-90 days; with more than 4 hours, for 70% of the time.

 

Diabetes – A1C from the last two weeks

If you are insulin dependent you will need an ITDM form from the last 45 days.

Cardiovacular Disease(s) – You will need to bring a copy of your most recent INR – International Normalized Ratio number

There is an eye exam, and a urinalysis.

Please be ready to use the restroom when you arrive

please complete all your paperwork

 

After setting up your appointment with one of our staff members you will need to fill out your medical paperwork online. This paperwork must be completed at least 30 minutes PRIOR to your appointment.

We will reschedule your appointment if

  1. your online paperwork is not completed in the requested timeframe 
  2. you are more than 5 minutes late for your scheduled time. 

Do you take Blood Thinner or Anticonvulsant medications

Have you had a ECHO or ETT test recently?

Check all that Apply

Who will be paying for your DOT

ContactUs@TouchofWellness.biz

309.321.8412

1101 West Jackson Street

Suite A Morton, IL 61550