The Crane/Hoist Physical Examination is the form the Montana Crane & Hoist Operator Program, run by the Montana Department of Labor and Industry's Business Standards Division, uses for a physician to report an operator's physical exam. If you are looking for the Montana crane operator physical form, this is the document. First and Second Class Crane/Hoist Operators and applicants use it before a license is issued or renewed. On this page you can fill out the form online on FillingPDF and download or print the completed PDF; the program publishes the original PDF at the agency's website.
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What is Crane/Hoist Physical Examination – Montana?
The Crane/Hoist Physical Examination is the form the Montana Crane & Hoist Operator Program provides for a physician to report the physical examination of a crane or hoist operator or applicant and to state whether that person is physically competent to safely operate crane/hoisting machinery.
The form gives the physical examination authority as MCA 50-76-103(2), (b), (ii). It has two parts. The first page identifies the operator (name, Social Security Number and, if applicable, license number), gives space for physician comments, collects the physician's name, address, license number and professional category, and ends with the physician's opinion and signature. The second page lists the mandated criteria the examination must meet:
- Vision of at least 20/30 Snellen in one eye and 20/50 in the other, with or without corrective lenses.
- Ability to distinguish colors, regardless of position, if color differences are required for operation.
- Adequate hearing, with or without a hearing aid, for the specific operation.
- Sufficient strength, endurance, agility, coordination and speed of reaction to meet the demands of operating the equipment.
- Normal depth perception, field of vision, reaction time, manual dexterity and coordination, and no tendencies to dizziness or similar undesirable characteristics.
The form states that physical defects or emotional instability that would be a hazard, or that could interfere with performance in the examiner's opinion, may be sufficient cause for disqualification. Evidence of seizures or loss of physical control is sufficient reason for disqualification. An operator who is physically or mentally unfit shall not operate equipment.
It is a medical report completed by the examiner, not a license application, and it is different from any generic physical form from another program or state.
Who needs to file Crane/Hoist Physical Examination – Montana?
First and Second Class Crane/Hoist Operators and applicants for those licenses need this form, because the program requires a biennial physical before a license is issued or renewed. The operator or applicant gives the form to their examiner.
- New applicants: must have the physical done within the past 180 days when they submit the application.
- Licensed First and Second Class operators: need a physical before each renewal, repeated every two years.
The examiner who completes and signs the form must be a physician, physician assistant or advanced practice registered nurse; the form asks for one of these three as the professional category. The operator's part of the form is the name, Social Security Number and, if applicable, license number. The form names no other person who may complete or sign it for the operator, and it does not describe licence classes other than First and Second Class.
When to file Crane/Hoist Physical Examination – Montana
Submit the form whenever you apply for or renew a First or Second Class crane/hoist operator license, because the program requires a biennial physical before issuance or renewal. New applicants must have the physical done within the past 180 days when they submit their application, so schedule the exam close to the application date. The form states that failing to submit the physical examination will delay the issuance of your license. It says to send the form together with your license fee payment, and it prints no separate due date.
Documents you need
- License fee payment, sent with the completed and signed physical examination form; the form does not state the amount, so ask the Crane & Hoist Operator Program for it.
How to fill out Crane/Hoist Physical Examination – Montana
Enter the operator's full name
Under CRANE/HOIST OPERATOR, write the first, middle and last name of the person who was examined.
Add Social Security Number and license number
Enter the operator's Social Security Number. Enter the License Number only if applicable, for example when you already hold a license.
Give the physician the mandated criteria
The examination must meet the criteria on the next page, covering vision, color, hearing, physical capability and depth perception. Ask the examiner to review them before completing the form.
Record physician comments
The examiner writes any remarks in the PHYSICIAN COMMENTS area.
Complete the physician information
The examiner prints their name and gives the street, city, state and ZIP code, plus license # and professional category: physician, physician assistant or advanced practice registered nurse.
Mark the physician's opinion
The examiner marks DO or DO NOT in the statement about whether the applicant is physically competent to safely operate crane/hoisting machinery.
Sign and date the form
The physician signs and dates the statement. The program requires the form to be completed and signed by the physician before it is sent.
Review and download the completed PDF
Check names, numbers and the physician's section for gaps, then download or print the completed PDF from FillingPDF and send it as described under How to submit.
How to submit Crane/Hoist Physical Examination – Montana
The form tells you to send it to the Montana Crane & Hoist Operator Program along with your license fee payment, after your physician has completed and signed it.
- By mail: Crane / Hoisting Operator Program, PO Box 200513, Helena, MT 59620-0513.
- Physical address (agency page): Crane / Hoisting Operator Program, 301 S. Park Avenue, 4th Floor, Helena, MT 59620.
- Questions: Professional Licensing Customer Service at (406) 444-6880 or [email protected], for people who have applied, are about to apply or are renewing.
A license fee payment goes with the form, but the form does not give the amount or the accepted payment methods. Ask the program for them before you send the package. The form names no other submission channel. The program's website is listed on the form as http://www.craneoperator.mt.gov. FillingPDF lets you fill out and download the PDF; submission follows the agency's channels above.
Common mistakes to avoid
- Sending the form before the physician has completed and signed it; the form says your physician must complete and sign it first.
- Submitting a physical done more than 180 days before a new application is filed.
- Leaving out the license fee payment; the form says to send it along with the payment.
- Skipping the physician's license number or professional category (physician, physician assistant or advanced practice registered nurse).
- Leaving the physician's opinion unmarked, with neither DO nor DO NOT circled before the signature.
- Having the examination done without checking it against the five mandated criteria listed on the second page.
- Omitting the license number when you are renewing; the form asks for it if applicable.
- Expecting the license to be issued on time when the physical has not been submitted; the form warns of delay.
Frequently asked questions
What is the Crane/Hoist Physical Examination form?
It is the Montana Crane & Hoist Operator Program form on which a physician reports a physical examination of a crane or hoist operator and states whether the person is physically competent to safely operate crane/hoisting machinery. The program uses it for license issuance and renewal.
Who needs the Montana crane operator physical form?
First and Second Class Crane/Hoist Operators and applicants. The program requires a biennial physical before a license is issued or renewed, and this form is how the physician reports it.
How recent must the physical be for a new crane license application?
New applicants must have the physical done within the past 180 days when they submit the application. Licensed operators need a physical before each renewal, repeated every two years.
Who can complete and sign the form?
A physician, physician assistant or advanced practice registered nurse. The form asks the examiner to print their name, address, license number and professional category, and to sign and date the opinion.
Where do I send the completed physical examination form?
Mail it to Crane / Hoisting Operator Program, PO Box 200513, Helena, MT 59620-0513, with your license fee payment. The agency page also lists a physical address, 301 S. Park Avenue, 4th Floor, Helena, MT 59620. Customer service is at (406) 444-6880.
What happens if I do not submit the physical examination?
Your license issuance will be delayed. The form states that failure to have the physical examination submitted to the program results in delay in issuance of your license.
What does the physician check on the examination?
The mandated criteria: vision of at least 20/30 Snellen in one eye and 20/50 in the other, color distinction when operation requires it, adequate hearing, sufficient strength and reaction speed, and normal depth perception and coordination. Seizures or loss of physical control are sufficient reason for disqualification.
Can I fill out the crane/hoist physical form online?
You can fill out the PDF online on FillingPDF and download or print it. FillingPDF is an independent service: it does not file the form or contact the program, and the physician must still complete and sign it before you send it to the program.
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