Medical Exam Report, Certificate and Verification

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Medical Exam Report, Certificate and Verification

Item Number:  279631

Price: $4.99

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Updated for 2015!
  • Medical Examination Report complies with final rule published April 23, 2015. Helps you comply with 49 CFR 391.43. 9 pages long. Contains applicable regulations, instructions to the medical examiner, and the form itself. 8-1/2" x 11".
  • Medical Examiner's Certificate laminated paper format, DOT medical card. Self-laminating, front laminate protects driver copy. Two-ply, tri-fold. 3-1/2" x 7-1/8" overall, 3-1/2" x 2-3/16" folded, 3-1/2" x 6-1/2" certificate detached.
  • Medical Examiner's National Registry Verification complies with DOT's 49 CFR 391.23 and 391.51. Snap out format, two-ply carbonless. Required to be used as of May 21, 2014. 8-1/2" x 11-3/4"

    NOTE: As of December 22, 2015 the Medical Examination Report and Medical Examiner's Certificate contained in this packet may be used inaccordance with 49 CFR ?391.43. On December 21, 2015, the FMCSA announced a 120-day grace period during which Medical Examiners can use either the current forms or these newly revised versions.