Most Common Forms
Please call the office at 508-620-1585 if you are unsure if you need to fill out the Federal diabetes or medication form.
Below is Dr. Austrager’s information for the self-certification form.
Howard Austrager, DC
License #: CH 2400
Registry #: 9105834189
Federal Insulin-Treated Diabetes Mellitus Assessment Form 5870
If you are taking insulin for either Type 1 or Type 2 Diabetes, this form needs to be completed by your physician prior to your DOT Physical appointment.
Federal Diabetes Form 5870Medication Form MSCA 5895
This form is needed if you are taking certain medications. If you are unsure, call the office before having your physician fill it out.
Medication Form MCSA 5895School Bus Form / 7D for Diabetes
This is form needed for school bus and 7D drivers who use insulin. This form is in addition to Fed Form 5870.
School Bus Diabetes Form