DOT Physicals

A Department of Transportation (DOT) physical examination must be conducted by a licensed "medical examiner" listed on the Federal Motor Carrier Safety Administration (FMCSA) National Registry.

The DOT exam is valid for up to 24 months. The provider may issue a certificate for less than 24 months if there is a condition that requires monitoring, such as high blood pressure.

If the examiner finds that the person is physically qualified to operate a commercial motor vehicle, they will issue a medical examiner’s certificate.

Please call 618-638-1343 to schedule your appointment with Ashley Hagerty, PA-C. Please review the appointment checklist below and fill out any required forms prior to your appointment.

DOT Preperation Checklist

If required, please have your treating physician fill out the following forms.

Driver Medication Form

Vision Evaluation Form

Insulin-Treated Form


Legal Relationship between Hospital and Physicians/Providers:
Massac Memorial Hospital employs Jonathan Walters, MD; Adam Connell, MD; Michael Hicks, MD; Thomas Staton, MD; Yusheng Dong, MD; Mallory Wittig, APRN, FNP-BC; Alyce Hannan APRN, FNP-BC; Amanda Reed, APRN, ACNS-BC; Ashley Hagerty, PA-C; Ashley Suggs, APRN, FNP-C, and Jessica Wright, APRN, FNP-C. All other physicians/providers, pathologists, radiologists, anesthesia providers, other hospital-based providers, my attending physician/provider and consulting physicians/providers are independent contractors and are NOT employees or agents of Massac Memorial Hospital. All such physicians/providers are independent contractors who have been granted privileges at this facility for care and treatment of their patients. I recognize that the independent contractor physicians/providers are not subject to supervision or control of Massac Memorial Hospital with respect to my treatment. I acknowledge that the employment agency status of physicians/providers participating in my care are not relevant to my selection of Massac Memorial Hospital/Massac Memorial Medical Clinics for my care. I acknowledge that any questions about the Independent Contractor Disclosure paragraph and the important information contained in it have been answered to my satisfaction.