Special Forms

Insulin Treated Diabetes Assessment Form 

Drivers who are prescribed insulin in order to treat diabetes must have their treating physician complete the Insulin Treated Diabetes Assessment form (ITDM) before scheduling their CDL physical. The form is valid for 45 days after completion, meaning drivers must complete their CDL physical within 45 days of obtaining the ITDM form. In addition, drivers will need to provide 3 months of blood glucose records, obtained from an electronic, downloadable glucometer. Drivers may be certified for up to one year. 

SPE Certificate Application (New Applicant)

SPE Renewal Application

The Skill Performance Evaluation program is for CMV drivers who drive in interstate commerce. The SPE certification allows drivers with missing or impaired limbs to drive CMVs across state lines if they have been fitted with (and are wearing) the right prosthetic device, and the driver can demonstrate the ability to drive the truck safely by completing on-and off-road activities. If the driver passes the driving test, he or she will receive a SPE certificate.  This application will need to be completed before obtaining a CDL physical.

Vision Waiver Packet

Vision waivers are available to drivers who have monocular vision (only able to see with one eye) or other eye conditions which may affect their ability to operate a commercial vehicle.  The vision waiver packet includes forms that should be completed by the drivers treating eye doctor. In addition, medical exams, employment history, driving experience and motor vehicle records must be submitted with the application. The FMCSA will make a final decision within 180 days of receipt of the complete application.

Please contact our office for further information. We are here to help, and are happy to answer any questions you may have about these forms, as well as provide forms for drivers to have completed by their treating physicians. 

Feel free to call us at (252) 448-4561

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115 West Jones Street | Trenton, NC 28585

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