Submit my physical

1Who you are

First name (full legal name)

Last name (full legal name)

Use the name on your medical card so the office can match it to your record.

Your emailRequired — this is where your renewal reminders go (90, 60 and 30 days before your card expires), plus a confirmation now. Use the address you check.

2Your exam

Date of your physical

Expiration printed on the new cardMost cards run 2 years. If yours says something else, enter exactly what's printed.

3Where you went

Clinic

4What you paid

Amount on the receipt

Up to $95.00, and never more than the receipt.

5Your receipt

Photo or PDF of the receiptIt must show the clinic, the date and the amount. Up to 5 files.

6Your new medical card

Photo of the new medical examiner's certificateRequired — the office uses it to confirm your new expiration date. Only the office can see it.

7Your driver's license

A clear photo of both sides is required. Only the office can see these.

Front of your driver's license

Back of your driver's license

8Anything else? (optional)

By submitting you're confirming the receipt is for your own DOT physical.