KDOR Motor Vehicle Website

Kansas Commercial Driver's License Holder Medical Self Certification

The Kansas Division of Vehicles is collecting medical self-certifications for all Kansas CDL holders as required by the Federal Motor Carrier Safety Regulations, 49 CFR Part 383, 384, 390 & 391. In addition to completing this electronic form, if you are subject to presenting your DOT medical card it must be uploaded at the end of this transaction or faxed into our department. Fax: 785-296-5859

(With no dashes or spaces)
Category 1. Interstate, and I am both subject to and meet 49 CFR Part 391. A copy of DOT medical card and this certification must be submitted to the state driver licensing agency.

Category 2. Interstate, but operating exclusively in transportation or operations excepted under 49 CFR 390.3(f), 391.2, 391.68, or 398.3. Only this certification must be submitted to the state driver licensing agency.

Category 3. Intrastate, and I am both subject to and meet state driver medical qualification requirements. This requires the driver to carry a medical card; however, only this certification must be submitted to the state driver licensing agency. Requires Intrastate only "K" restriction on CDL credential.

Category 4. Intrastate, but operating exclusively in transportation or operations excepted from all or parts of the state driver qualification requirements. Only this certification must be submitted to the state driver licensing agency. Requires Intrastate only "K" restriction on CDL credential.
(Do Not Enter Dashes ex: 9999999999)