If You Take These Medications, You Might Not Get A CDL

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If You Take These Medications, You Might Not Get A CDL

If you suffer from anxiety, depression or other mental illnesses but take medication to treat the symptoms, you may be ineligible for a CDL or you may need a Medical Release Opinion letter.

Millions of Americans suffer from anxiety, depression and other mental illnesses or chemical imbalances. The symptoms of these illnesses can range from minor to severe and most are easily controlled with medication. The medications given for mental illnesses can help suffers live a normal, happy life.

According to the FMCSA, “individuals who live under chronic emotional upsets may have deeply ingrained maladaptive or erratic behavior patterns. Excessively antagonistic, instinctive, impulsive, openly aggressive, paranoid or severely depressed behavior greatly interfere with the driver’s ability to drive safely. Those individuals who are highly susceptible to frequent states of emotional instability (schizophrenia, affective psychoses, paranoia, anxiety or depressive neurosis) may warrant disqualification.

For more information follow this link: https://goo.gl/9t6ttF

“Careful consideration should be given to the side effects and interactions of medications in the overall qualification determination. See Psychiatric Conference Report for specific recommendations on the use of these medications and potential hazards for driving.”

A 2009 FMCSA Medical report states:

It is the opinion of the MEP that all individuals with a history of the following psychiatric disorders should undergo additional medical and psychiatric evaluation to further assess functional ability before being considered qualified to drive a CMV:
•Psychotic Disorders
•Bipolar Disorders
•Major Depressive Disorder with a history of psychosis, suicidal ideation, homicidal ideation or a suicide attempt
•Obsessive Compulsive Disorder
•Antisocial Personality Disorder

The MEP believes that all individuals currently taking benzodiazepines or similar drugs which act on benzodiazepine receptors should be immediately prohibited from driving a CMV.

Individuals who take benzodiazepines for any length of time should not be allowed to drive until the drug has been cleared from their system (i.e., within seven half-lives of the drug and any active metabolites). Chronic users of benzodiazepines (i.e., regular use for more than a month) should also wait an additional week after the drug has cleared from their system before resuming driving to ensure that the drug has been completely eliminated. It is also suggested that FMCSA provide information regarding the half-life and seven half-lives of benzodiazepines and active metabolites to medical examiners for use at the time of examination.

Given the functional impairments and increased crash risk associated with benzodiazepine use, the MEP believes that:
•individuals currently taking benzodiazepines not be allowed to drive a CMV
•individuals who are taking benzodiazepines should stop taking them long enough ahead of driving for them to be cleared from their systems before being allowed to drive a CMV (it takes seven half lives for a drug to be completely eliminated from the body)
•chronic users of benzodiazepines should wait an additional week after the drug has been cleared from the body (i.e., seven half lives plus one week) before driving a CMV to ensure that it has been completely eliminated.

The MEP is of the opinion that all individuals currently taking lithium be excluded from driving a CMV at night.

What to do?

Give your Certified Medical Examiner all the information so he may contact and discuss with the prescribing doctor and if necessary get a ………………..

……………………………Medical Release Opinion

To ensure that the medical examiner can complete the DOT physical exam at your appointment you should bring a Medical Release Opinion letter from your treating physician. You can download instructions and a letter template here, or refer your treating physician to this page for the necessary information.

Download Medical Release Opinion information here.

If you do not have the necessary documentation with you, for the DOT physical exam, the medical examiner may have to temporarily disqualify your medical certificate. You will need this documentation before you can be reconsidered for qualification for a medical certificate.

Medical Conditions

These are the medical conditions listed on the FMCSA long form for which you should have supporting documentation for the medical examiner:

Illness or injury within the last 5 years • Head/Brain injuries, disorders or illnesses • Seizures, epilepsy • Eye disorders or impaired vision (except corrective lenses) • Ear disorders, loss of hearing or balance • Heart disease or heart attack; other cardiovascular condition • Heart surgery (valve replacement/bypass, angioplasty, pacemaker • High blood pressure • Muscular disease • Shortness of breath • Lung disease, emphysema, asthma, chronic bronchitis • Kidney disease, dialysis • Liver disease • Digestive problems • Diabetes or elevated blood sugar controlled by diet or pills or insulin • Nervous or psychiatric disorders e.g. severe depression • Loss of, or altered consciousness • Fainting, dizziness • Sleep disorders, pauses in breathing while asleep, daytime sleepiness, loud snoring • Stroke or paralysis • Missing or impaired hand, arm, foot, leg, finger, toe • Spinal injury or disease • Chronic low back pain • Regular, frequent alcohol use • Narcotic or habit forming drug use

As always if you have questions drop me a message or a phone call and we will help you in any way we can:

By: Dr. Michael Tigges

Contact Us

We’d love to hear from you. Please use one of the various methods below and we’ll look forward to connecting with you soon!

Phone Number:
615-452-1575

Email Address:
info@samedaydot.com

Our Location:
529 Hartsville Pike
Gallatin, TN 37066

Right next to Sumner Regional Medical Center across from Perkins Drugstore. Parking for your big rig next door in the Food Lion parking lot.

About Us

Dr. Michael J. TiggesDr. Michael Tigges

Certified DOT Medical Examiner
Chiropractic Physician

Certification:

Dr. Tigges is one of the first in TN to become a certified DOT Medical Examiner of the United States Federal Government. The National Registry of Certified Medical Examiners requires all medical examiners performing physical examinations for interstate commercial motor vehicle drivers to be trained and certified in FMCSA physical qualification standards.


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Same Day DOT Physicals Drug & Alcohol Testing Gallatin, TN

http://dotphysicaldoctor.com/tn/dr-michael-tigges/

What Drivers Are Saying

“Great place to go to! Very nice and welcoming from the moment you walk into the door. I would highly recommend everyone to go to Dr Tigges for any medical needs. The lady in the office is extremely nice as well.”
Justin M

“Very short wait time. Super friendly staff. I always get stressed when I get a physical for work, which causes blood pressure issues. The staff kept me calm and got me through it just fine. The doctor had great information to offer that will help me in the future.”
Robert D

“Great experience! Friendly professional staff. I will definitely be using them again and I highly recommend them!”
Damar N

“Very good group of people. I was a walk in. Only wait time I had was me filling out papers. Staff was excellent, made me feel like I was family. Tigges did a great job of explaining things I didn’t know and he didn’t miss a thing in the exam. I would recommend him to anyone. I am even going to send my wife there for chiropractic care. I will return for my next DOT physical.again!”
Dwight C

“From the moment I walked in until my physical was completed the staff & Dr. Tigges was extremely nice, professional, & very welcoming. It made me feel alot more at ease for the DOT physical. I also did not have to wait long at all. I would highly recommend Dr. Tigges to anyone that needs a DOT!! Best in this area!!”
Toya G

DOT Medical Exam Services

  • DOT/CDL MEDICAL EXAM  ~  Our prices are the lowest in the area. $75.
  • Certified DOT Drug Testing
  • Certified DOT Breath Alcohol Testing
  • School Bus Driver Physicals
  • Pre-employment Physicals
  • DOT Random Drug Testing Programs

We will gladly answer any questions you may have prior to your exam.

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Where are you going this year with your HEALTH?

Where are you going this year with your HEALTH?       office-from-street

Get Your Screenings Chiropractic and Medical

Now it’s time to kick your year off by making a doctor’s and Chiropractic appointment to really understand and access your current health status. Getting a physical will test your blood pressure, cholesterol, triglycerides and numbers, blood sugar, vitamin deficiencies and will screen for other potential ailments. Find out what your number are and then do something about it-Diet-Exercise and the RIGHT supplements-don’t guess.medical-issues

Find a Workout You REALLY Like

Every January, the gym is packed with people hogging up the treadmills and elliptical and by February they are gone. Why? Sometimes folks get bored or they burn out. The key to working out consistently is finding workouts that you can’t get enough of. What’s my favorite workout? Rock climbing at Climb Nashville during the Winter, Slackline and wakeboarding during the Summer- If I can do it (almost 54 years of age) you can to. https://youtu.be/3pE00qEyibU  click here to see Slacklinehealth6

If you have a gym membership, explore the classes they offer. You might discover that you really like Spin, Hip-hop dance or CrossFit. If you don’t have a gym membership, you can find a variety of workouts on your cable’s On Demand, Hulu and/or online—or keep it old school and use DVDs. But whatever you do, just get to sweatin’ 3-5 days a week and don’t forget to add in days of strength training too!

Get More Zzzzs In and get more Water!!!!!!!!

Sleep is incredibly important. It’s our bodies’ way of healing and refueling. It also gives our brains time to process and strengthen our memories and is great for our mental health, productivity and mood.

To get in more Zzzz’s, try to not drink coffee six hours before bed, rest before bedtime to take down those stress levels, try not to watch television or internet surfing in bed, don’t eat super heavy meals and drink a lot of liquor before bed, don’t sleep with the television on and keep your bedroom nice and dark. If that’s not working try natural supplements but get expert advice about what to take and not. What you don’t know can hurt you.

Try Going With-out Eating Meat One Day (or More) A Week

health9

There is something to be said about eating less red and processed meats and incorporating more of a high fiber plant-based diet of fruits, vegetables, whole grains, lentils and beans, nuts and healthy oils. Studies have found that a high fiber plant-based diet helps improve health, will help you lose weight, reduce your risk for certain cancers and can stabilize and even reverse chronic illnesses such as heart disease, high blood pressure and diabetes.

Always start slow, one day a week. It might be hard, but you can get creative with it. Take the meat out of your chili, tacos and burritos and add in more chopped veggies. Or eat lentil and other low-sodium hearty soups with fiber filled salads.

Check out two of my recommended web sites to motivate and steer you’re the right way for Diet and Exercise.

http://www.marksdailyapple.com/

https://youtu.be/3pE00qEyibU  click here to see Slackline

http://www.wheatbellyblog.com/

 

 

 

 

 

 

 

Same Day DOT Physicals Drug & Alcohol Testing Gallatin, TN

Same Day DOT Physicals
Drug & Alcohol Testing
Gallatin, TN

DOT Medical Exam Services

  • DOT/CDL MEDICAL EXAM  ~  Our prices are the lowest in the area. $75.
  • Certified DOT Drug Testing
  • Certified DOT Breath Alcohol Testing
  • School Bus Driver Physicals
  • Pre-employment Physicals
  • DOT Random Drug Testing Programs

We will gladly answer any questions you may have prior to your exam.

We provide a friendly atmosphere that is stress free. Our office staff Virginia and Shelia will do whatever it takes to help you. We are a TeamCME Clinic! Nationally Recognized as a Provider of Fair, Ethical DOT Physical Exams!

No Waiting! We are committed to getting you back on the road in no time. Our goal is to perform a complete exam and have you on your way within an hour.

We print your certificate out right after you pass your physical – PLUS a Laminated Medical Card.

For more information see our Same Day DOT Physicals Drug & Alcohol Testing website.

We take care of your DOT Medical Card process and get it done right the first time at Same Day DOT Physicals Drug & Alcohol Testing!

 

Other Services

    • Digital X-ray on site
    • Chiropractic treatment
    • Physiotherapy
    • Rehabilitative exercises
    • Workers’ Comp and Personal Injury Auto Accident Whiplash Treatment
    • Physical Abilities Testing Certified
    • Nutrition

 

Local Business Information

Food Lion Market. Perkins Drugs. Sumner Regional Medical Center. Hardens. Sonic Drive In.

DOT Physical Doctors Driver Friendly™ DOT Physical Locations

Same Day DOT Physicals
Drug & Alcohol Testing
Gallatin, TN

DOT Medical Exam Services

  • DOT/CDL MEDICAL EXAM  ~  Our prices are the lowest in the area. $75.
  • Certified DOT Drug Testing
  • Certified DOT Breath Alcohol Testing
  • School Bus Driver Physicals
  • Pre-employment Physicals
  • DOT Random Drug Testing Programs

We offer same day appointments and while appointments are preferred, walk-ins are welcome.
Our office staff Virginia and Shelia are here to help.
No Waiting! We are committed to getting you back on the road in no time.

We are a TeamCME Clinic! Nationally Recognized as a Provider of Fair, Ethical DOT Physical Exams!

For more information see our Same Day DOT Physicals Drug & Alcohol Testing website.

We take care of your DOT Medical Card process and get it done right the first time at Same Day DOT Physicals Drug & Alcohol Testing!

 

Other Services

    • Digital X-ray on site
    • Chiropractic treatment
    • Physiotherapy
    • Rehabilitative exercises
    • Workers’ Comp and Personal Injury Auto Accident Whiplash Treatment
    • Physical Abilities Testing Certified
    • Nutrition

 

Local Business Information

Food Lion Market. Perkins Drugs. Sumner Regional Medical Center. Hardens. Sonic Drive In.

Serving Tennessee local areas: Gallatin, Hendersonville, Portland, Hartsville, Westmoreland, Lafayette, Nashville, Sumner County.

DOT Physical Without Hassles

Guidebook cover - 30Questions about getting
your Medical Card
Get the GUIDEBOOK here

More Questions?Get your questions answered here

What Drivers Are Saying

“Great place to go to! Very nice and welcoming from the moment you walk into the door. I would highly recommend everyone to go to Dr Tigges for any medical needs. The lady in the office is extremely nice as well.”
Justin M

“Very short wait time. Super friendly staff. I always get stressed when I get a physical for work, which causes blood pressure issues. The staff kept me calm and got me through it just fine. The doctor had great information to offer that will help me in the future.”
Robert D

“Great experience! Friendly professional staff. I will definitely be using them again and I highly recommend them!”
Damar N

“Very good group of people. I was a walk in. Only wait time I had was me filling out papers. Staff was excellent, made me feel like I was family. Tigges did a great job of explaining things I didn’t know and he didn’t miss a thing in the exam. I would recommend him to anyone. I am even going to send my wife there for chiropractic care. I will return for my next DOT physical.again!”
Dwight C [contact-form][contact-field label=’Name’ type=’name’ required=’1’/][contact-field label=’Email’ type=’email’ required=’1’/][contact-field label=’Website’ type=’url’/][contact-field label=’Comment’ type=’textarea’ required=’1’/][/contact-form] 

QR-SameDayDOT

https://goo.gl/S1zfHx

What are the blood pressure requirements to pass the DOT physical?

blood-pressure

What are the blood pressure requirements to pass the DOT physical?
Here are the medical guidelines according to the Federal Motor Carrier Safety Regulations (FMCSRs). Note that employers are allowed to impose more stringent medical requirements.
 A driver with a BP of less than 140 / 90 may be medically certified to drive for a two-year period.
 A driver with a BP of 140 – 159 systolic and /or a BP of 90-99 diastolic, has stage 1 hypertension, and may be medically certified to drive for a one-year period. Certification examinations should be done annually thereafter and should be at or less than 140/90.
 A driver with a BP of 160-179 systolic and/or a BP of 100-109 diastolic, has stage 2 hypertension, and is a candidate for antihypertensive drug therapy. The driver is given a one-time certification of three months to reduce his or her blood pressure to less than or equal to 140/90. Provided treatment is well tolerated and the driver demonstrates a BP value of 140/90 or less, he or she may be re-certified for one year from the date of the initial exam. The driver is certified annually thereafter.
 A driver with a BP at or greater than 180 systolic and / or 110 diastolic has stage 3 hypertension and is disqualified. The driver may not be qualified, even temporarily, until blood pressure is reduced to equal to or less than 140/90 and treatment is well tolerated. The driver may be certified for 6 months and biannually (every 6 months) thereafter if at recheck BP is equal to or less than 140/90.
Drivers with Type 1 or Type 2 diabetes, or kidney disease require treatment if their blood pressure rises above 130/80, since they already have a high risk of heart disease.

http://www.fmcsa.dot.gov/faq/what-basis-fmcsas-recommendations-regarding-high-blood-pressure

Use Your FSA or HSA Account for Chiropractic Care Before The End of the Year

Use Your FSA or HSA Account for Chiropractic Care Before The End of the Year

office-from-street

We are nearing the end of the year, and depending on your health plans, you may participate in either a Flexible Spending account (FSA) or a Health Savings Account (HSA) program. In this blog post, we want to inform you of all the chiropractic services covered by these programs and to remind you to use your entire FSA budget before the year quickly comes to an end.

Chiropractic services are covered under FSA/HSA

Most people don’t think of chiropractic care being covered by these FSA and HSA programs. Chiropractic care is designed to take care of your body and improve your overall health and quality of life. Aligning your body’s muscles, joints and nerves provides long-term relief and prevents future injuries. Chiropractic services can help aid in pain management and so much more. If you’re experiencing pain and would like a more natural, drug-free option, use your remaining balance for chiropractic services.

The difference between FSA and HSA

FSA

Flexible Spending Accounts (also known as a flexible spending arrangement), or FSAs, are a use-it-before-you-lose-it type of program. An FSA is a tax-free account option you put money into that you use to pay for certain out-of-pocket health care costs. FSA accounts are great for routine expenses, like dental cleanings and checkups with your doctor. However, if you don’t use your allocated funds by the end of the year, any remaining funds will go back to your employer.

HSA

Health Savings Accounts, or HSAs, are for taxpayers who are enrolled in a high-deductible health care plan. Like the FSA accounts, HSAs are not subject to federal income tax at the time of deposit. However, any unused HSA funds that are unused at the end of the year can roll over to the next year.

What services are covered?

A qualified medical expense is one for medical care as defined by Internal Revenue Code Section 213(d). The expenses must be used primarily to alleviate or prevent a physical or mental defect or illness. Fortunately, many of our services at Tigges Chiropractic fall under these guidelines, including:

  • Neck pain
  • Back pain
  • Whiplash
  • Herniated and bulging discs
  • Chronic pain
  • Stress relief and more.
  • Check www.irs.gov for more information on covered expenses. Call us today at (615) 452-1575 to set up your appointment before the end of December. We offer free consultations and provide safe, beneficial, and well-rounded health care experiences for our patients

What to Expect During Your DOT Physical

What to Expect During Your DOT Physical

The Department of Transportation requires some drivers to get regular physicals to make sure they can drive safely. If any of the following apply to you, you must get a DOT physical and carry a DOT medical certificate when you drive a commercial vehicle:

  • You are paid to operate a motor vehicle that holds nine to 15 passengers; you drive the vehicle more than 75 miles from where you report to work; you operate this vehicle for interstate commerce purposes
  • You operate a motor vehicle with a gross combination weight rating, gross vehicle weight, gross vehicle weight rating, or gross combination weight of at least 10,001 pounds; you operate this vehicle for interstate commerce purposes
  • You transport hazardous materials in certain quantities

 

DOT Restrictions

There are some restrictions for commercial drivers who have certain health problems. If you take injectable insulin for Diabetes, for example, you cannot get a commercial driver’s license. You must have at least 20/40 correctable vision in both eyes. The DOT does allow you to wear contact lenses or glasses to improve your vision. You cannot use narcotics, amphetamines, or other habit-forming drugs if you want to obtain or renew your commercial driver’s license.

Driver Health History 

Before meeting with the examiner, you must fill out the DOT physical form. The first section has room for your name, Social Security number, birthdate, driver’s license number, address, and telephone number. The second section asks about your medical history. You must indicate whether you have had any of the following:

  • Brain injuries or neurological disorders
  • Epilepsy or seizures
  • Loss of hearing
  • Impaired vision
  • Kidney disease
  • Digestive problems
  • Psychiatric disorders
  • Dizziness or fainting
  • Paralysis
  • Stroke
  • Missing limbs
  • Spinal cord injuries
  • Chronic pain

 

You should answer each question truthfully, or you could face serious legal consequences in the future.

DOT Physical Exam Procedure

If you want to comply with federal law, a qualified medical examiner must complete your DOT physical form. A qualified examiner may be a doctor, physician’s assistant, nurse practitioner or Chiropractor who has been federally certified by the FMSCA. The examiner will review your health history and ask you to list the medications you take on a regular basis. During your DOT physical, the examiner will also do the following:

  • Check your pulse and blood pressure
  • Perform a vision test
  • Observe your general appearance
  • Examine eyes ears throat
  • Listen to your heart and lungs
  • Check for spine deformities
  • Perform a neurological exam
  • Press on your abdomen to check for abnormalities
  • Perform a hernia check

 

DOT Physical Forms 

Once the medical examiner completes all the DOT physical requirements, you will discuss any hazards created by your health history or current medical condition. The examiner must document these hazards on your DOT physical form and determine whether you meet the standards for receiving a medical certificate.

If you meet the standards and do not require periodic medical monitoring, your certificate will be valid for two years. In some cases, the medical examiner will issue a certificate that lasts for only three months, six months, or one year. The examiner will also note whether you must wear a hearing aid or corrective lenses. If you do not meet the standards, the examiner will not be able to issue a valid medical certificate.

DOT Physicals at Your Convenience 

https://samedaydot.com/tennessee-dot-physical/

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Pass Your DOT Medical Exam!  Dr. Tigges knows how important it is that you continue your livelihood as a commercial driver. With his extensive knowledge of the DOT Physical Exam medical guidelines, Dr. Tigges will steer you through the DOT Physical Exam requirements so you can Keep on Truckin’. Having affordable and fast testing is crucial to keep drivers on the road and that’s what we strive to provide our clients.DOT CERTIFIED AD1

Tennessee CDL and DOT Medical Card Requirements

Tennessee CDL and DOT Medical Card Requirements
Beginning January 30, 2012, all CDL Drivers in the state of Tennessee are now required to self-certify to a single type of commercial operation. You are responsible to provide Tennessee Department of Safety & Homeland Security with your self-certification of operating status by January 30, 2014. Same Day DOT Physicals Drug & Alcohol Testing in Gallatin, TN is now proud to offer Department of Transportation Certified Medical Physicals (DOT Physicals) to satisfy the new DOT Medical Card Requirements.
Based on this self-certification, you may need to provide the Tennessee Department of Safety and Homeland Security (TDOSHS) with a current medical examiner’s certificate and show any variance you may have to obtain or keep your CDL and Same Day DOT Physicals Drug & Alcohol Testing is proud to offer the necessary services to all Tennessee CDL Drivers and DOT Employees.

Same Day DOT Physicals Drug & Alcohol Testing
GALLATIN, TN
CAN OFFER A COMPLETE SOLUTION TO OBTAINING YOUR CDL AND DOT MEDICAL CARD.
FOR JUST A $75 FEE, YOU CAN COMPLETE THE PROCESS TODAY!
MONDAY – FRIDAY, 7AM – 5PM, WALK-INS WELCOME.

HERE ARE SOME IMPORTANT THINGS TO KNOW ABOUT KEEPING YOUR CDL AND DOT MEDICAL CARD CURRENT:
INTERSTATE NON-EXCEPTED
You must meet the Federal DOT medical certificate requirements.
INTRASTATE NON-EXCEPTED
You must meet the medical requirements for the State of Tennessee.
If you do not provide TDOSHS with your self-certification and medical certificate by January 30, 2014, TDOSHS will notify you that you are no longer medically certified to operate a CMV in non-excepted Interstate commerce. TDOSHS will then remove all your CDL privileges from your license.
SUBMIT YOUR SELF-CERTIFICATION AND MEDICAL CERTIFICATE TO TENNESSEE DEPARTMENT OF SAFETY AND HOMELAND SECURITY
Submit the following two documents:
1. SUPPLEMENTAL APPLICATION FOR COMMERCIAL DRIVER LICENSE – Visit the TN Government Website to explore the Tennessee Department of Safety and Homeland Security.
2. Copy of your valid DOT MEDICAL CARD (the medical card, not the long form). Enlarge the copy to ensure that all information is legible.
By Mail:
Tennessee Dept. of Safety and Homeland Security
Commercial Driver License Division – Med Cert
1148 Foster Ave
Nashville, TN 37243
By Fax:
615-401-7674
By Email:
DI.CDL.Medcert@tn.gov
if by email please send the scanned copies in a PDF.
For questions please call 615-687-2312. Please have your commercial driver license number readily available.
KEEP YOUR MEDICAL CARD CURRENT WITH TN DEPARTMENT OF SAFETY
The Tennessee Department of Safety and Homeland Security will be adding your medical certification status and the information on your medical examiner’s certificate to your Commercial Driver’s License System (CDLIS) record. CDL holders required to have a ”certified” medical status who fail to provide and keep up-to-date their medical examiner’s certificate with TDOSHS will become ”not-certified”.
Before your medical card expires you must have a new medical examination and obtain a new medical certificate. You are responsible for providing your valid medical certificate to TDOSHS.
If your medical card expires, TDOSHS will notify you that you are no longer medically certified to operate a CMV in non-excepted Interstate commerce. TDOSHS will then remove all your CDL privileges from your license.
You may submit your new medical certificate by mail, fax, or email, as described above
Have questions? Call Same Day DOT Physicals Drug & Alcohol Testing 615-452-1575 Today. [contact-form to=’info@samedaydot.com’ subject=’Tennessee CDL and DOT Medical Card Requirements’][contact-field label=’Name’ type=’name’ required=’1’/][contact-field label=’Email’ type=’email’ required=’1’/][contact-field label=’Website’ type=’url’/][contact-field label=’Comment’ type=’textarea’ required=’1’/][/contact-form]