The long form is not accepted by HIPAA (Health Insurance Portability and Accountability Act) rules and regulations and it does not provide the driver's signature, which is required for medical certification.
In order for the CDL office to process your medical certification, two documents must be sent to DI.CDL.MEDCERT@tn.gov in PDF format:
- Affidavit Self-Certification
- Medical Examiner Certification (Form MCSA 5876)
For added convenience you may also Renew your CDL; Order a Duplicate CDL; and submit your Self-Certification Affidavit and Medical Exam Certificate online at: