Endocrinologist Evaluation Checklist

Form Template

The stringent requirements of a Commercial Driver’s License (CDL) are more demanding than a typical driver’s license.

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Commercial motor vehicle drivers with diabetes must receive a Federal Diabetes Exemption to maintain their CDL. To ensure that the safety and well-being of passengers and other drivers on the road, evaluating the overall health and well-being of the driver with diabetes is important.

The Endocrinologist Evaluation Checklist Mobile App is a part of the overall diabetes exemption checklist. It is administered by a licensed endocrinologist to determine if a driver can operate a commercial motor vehicle safely. This app may be customized to include fields such as initial diagnosis of diabetes mellitus, recent hypoglycemic reactions, hospitalizations, and diabetes management by medication or insulin injections or pump. Taking insulin should not have to be the end of a commercial driver’s career, and this app helps to ensure that the proper exemption can be obtained.

Since this software builds electronic records that replace paper forms, this process can be performed faster and more efficiently. And, it can be accessed in the field with a mobile device, such as a smartphone or tablet. This app is particularly helpful to large vehicle operations like public transit systems that must stay in compliance with safety licensing standards. CDL testing is an effective way to increase traffic safety on every highway and city street.

This app generates a PDF report that can be shared electronically. A copy is stored in your GoCanvas account for your safety records.

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