• Helps you comply with DOT's 49 CFR §391.43
• Both the Medical Examination Report and Medical Examination Certificate are required by the DOT
• This DOT medical exam form is 8 pages long
• Contains applicable regulations, instructions to the medical examiner, and the form itself
• Measures 11" x 8-1/2"

Interested in an electronic version of this form?
Contact us at customsolutions@jjkeller.com or 1-800-843-3174, ext. 2675 to discuss. Learn more.

6045 (649-F) -  Medical Examination Report Only -  Medical Examination Report - 6045 (649-F)
Size : 8-1/2" x 11"
Number of Plies : 1
Format : Sheet


---

View a sample Medical Examination Report.