25cc2599_Affairs_Forms_and_Publications__Description
[Form] Application for Intrastate Medical Waivers To Operate Class A,B, Or C Commercial Motor Vehicles [Instructions] A copy of the results of a recent DOT medical examination performed pursuant to 49 CFR 391.43, upon which the examining physician has indicated that you are only qualified to operate a commercial motor vehicle with an intrastate medical waiver. Your employment driving record for the previous five years. Your current employer's letter(s) of recommendation, including a certification that you will be engaged only in intrastate commerce within the Commonwealth of Massachusetts. [Description] 
This form is used to request a medical waiver to operate Class A, B, or C Commercial Motor Vehicles.
Massachusetts RMV - Medical Affairs Forms and Publications
Description