How to Fill Out and Submit the NC CDL-MED-1: Form, Filing, and Lapses

The NC CDL-MED-1 form is North Carolina’s one-page self-certification that every CDL holder files to tell NCDMV what kind of commercial driving they do and whether they are required to carry a federal medical card. You download it from the NCDMV website, check one of four boxes describing your type of operation, fill in your identifying details, sign it, and send it to NCDMV by email, mail, or in person.¹ File it when you first get a CDL, whenever your type of operation changes, and when you renew your medical certification.

One thing to know before you start: as of June 28, 2025, NCDMV no longer accepts paper Medical Examiner’s Certificates from drivers. Your examiner transmits the exam results electronically through FMCSA’s National Registry II system, and that record flows to your North Carolina commercial driver file on its own. The CDL-MED-1 is a separate filing, and you still have to send it in yourself.²

Pick the Right Operational Category

The only real decision on the CDL-MED-1 is which of four boxes to check. Pick wrong and you may end up carrying a medical card you don’t need, or driving without one when the law says you should have it. The categories split on two questions: do you cross state lines, and does your work fall under a federal or state exemption from medical certification?³

Non-Excepted Interstate. You drive across state lines or international borders and must carry a valid Medical Examiner’s Certificate. This covers most long-haul and regional truckers. You have to meet the full federal physical qualification standards under 49 CFR Part 391.¹
Excepted Interstate. You cross state lines but only perform work that is exempt from the federal medical rules. The federal exemptions cover government transportation, school bus operations, fire trucks and rescue vehicles in emergencies, occasional personal property transport, and transportation of sick or injured persons. Covered farm vehicle drivers are also exempt. You file the CDL-MED-1 but do not need a medical certificate.⁴⁵
Non-Excepted Intrastate. You drive only within North Carolina but must meet the state’s medical requirements, which mirror the federal ones. Your license carries a “K” restriction limiting you to intrastate operation, and a DOT medical card is required.¹
Excepted Intrastate. You drive only within North Carolina and perform work exempt from the state’s medical certification requirements. Your license carries the “K” restriction, and no medical card is needed. The same categories of exempt operations apply: government vehicles, farm equipment, emergency services.¹

If your duties change, file a new form. A driver who moves from intrastate hauls to interstate runs needs a fresh CDL-MED-1 reflecting the new category. Driving under the wrong classification can put your license at risk.

Fill In the Form

The form itself is short. You need your full legal name, date of birth, Social Security number, and your North Carolina driver license number.¹ Check one box for your operational category, sign and date the bottom, and that’s it.

You do not need to attach a Medical Examiner’s Certificate. Under the NRII system your examiner sends that information to the state electronically, so a paper copy from you is no longer accepted anyway.² One caveat: make sure your DOT physical was performed by a medical examiner listed on the FMCSA National Registry. If the examiner is not registered, the exam results will not transmit to the state, and you will effectively be uncertified no matter what paperwork you have in hand. You can search for certified examiners by city, state, or zip code on the National Registry site.⁶

How to Submit It

NCDMV asks that you use only one of these three channels:¹

Email. Send the completed form to CDLmedical@ncdot.gov. This is the fastest option and gives you a sent-message record.
Mail. NCDMV Data Capture Imaging Unit, 3126 Mail Service Center, Raleigh, NC 27699-3126. Keep a copy, and consider certified mail so you can prove when it arrived.
In person. Any local NCDMV driver license office will accept the form. Office locations and hours are listed at ncdot.gov/dmv. Staff can confirm receipt on the spot.

Pick one method and stick with it. Sending the same form through two channels creates duplicate records and can slow processing on both.

When You Need to File a New One

Three events require a fresh CDL-MED-1:

When you first obtain a North Carolina CDL.
Whenever your type of commercial operation changes, so that a different box on the form now applies.
When you renew your medical certification after a new DOT physical.¹

The renewal timing is driven by your medical certificate, which is good for up to two years for a healthy driver and can be issued for shorter windows if a condition needs monitoring.⁷ Line up the new physical before the old certificate expires.

What Happens If Your Medical Certification Lapses

The penalties escalate fast. Once NCDMV is notified that your medical certificate has expired, which now happens automatically through the NRII electronic feed, the state sends you a notice. You have 30 days to respond with a new certification, or your entire North Carolina driving privileges, not just your CDL, will be canceled.²

Under North Carolina law, if you fail to comply with the medical certification requirements within 60 days of receiving notice, the Division automatically downgrades your CDL to a regular Class C driver license.⁸ At that point you cannot operate any vehicle requiring a CDL until you complete a new physical, have the examiner transmit the results through NRII, submit a fresh CDL-MED-1, and go through the reinstatement process. Scheduling the next DOT physical a few weeks before your current certificate expires is the simplest way to avoid any of this.

1
North Carolina Department of Transportation. CDL-MED-1 Medical Certification of Driver Type
2
North Carolina Department of Transportation. Official NCDMV – Commercial Driver License
3
Federal Motor Carrier Safety Administration. Medical
4
eCFR. 49 CFR 390.3 – General Applicability
5
eCFR. 49 CFR 391.2 – General Exceptions
6
Federal Motor Carrier Safety Administration. National Registry of Certified Medical Examiners
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Federal Motor Carrier Safety Administration. Effect of the Length of Medical Certification on Safety
8
North Carolina General Assembly. North Carolina Code 20-37.13 – Commercial Drivers License Qualification Standards