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Pre-order new medical forms with 9/30/19 expiration date now!
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Medical Examination Certificate - LaminatedHelps you comply with 49 CFR §391.43 DOT medical card requirements.
(12)
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Medical Examination Report FormHelps you comply with 49 CFR §391.43 DOT medical card requirements.
(1)
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Medical Examination Certificate - SmallHelps you comply with 49 CFR §391.43 DOT medical card requirements.
(1)
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Overview
On Oct. 18, 2018, the Federal Motor Carrier Safety Administration (FMCSA) announced that it has changed its position on the use of recently expired Medical Examiner’s Certificates. The FMCSA has “requested that SDLAs (state driver’s license agencies) continue to accept the old versions with the 08/31/2018 expiration date,” according to the agency’s medical office. The FMCSA is “encouraging” use of the updated forms dated 9/30/2019, but those dated 8/31/2018 are still accepted. The FMCSA is expected to release yet another updated version of the medical exam forms, which could happen as soon as late November. Learn more and pre-order the updated forms with the 9/30/19 expiration date now.
- Complete package of forms required by 49 CFR 391.51
- Includes folder pre-printed with file contents and instructions for each form
- Contains the following forms:
- (1) Driver Qualification File Contents Sheet – Bond (3694)
- (1) Checklist for Qualification of New Drivers – 2 Copy Bond (1 White/1 Canary) (*506541)
- (1) Driver's Application for Employment – Bond (691)
- (2) Request for Check of Driving Record – 2 Copy Bond (1 White/1 Canary) (*506540)
- (1) Medical Examination Report – Bond (47375)
- (1) Medical Examiner’s National Registry Verification – 2 Copy Bond (1 White/1 Canary) (27033)
- (1) Record of Road Test – 2 Copy Bond (1 White/1 Canary) (652)
- (1) Certification of Compliance with Driver License Requirements – 2 Copy Bond (1 White/1 Canary) (1617)
- (1) Driver Statement of On-Duty Hours-New Hire – 2 Copy Bond (1 White/1 Canary) (3687)
- (1) Certification of Violations/Annual Review of Driving Record – 2 Copy Bond (1 White/1 Canary) (3685)
- (1) Employment Eligibility Verification (Form I-9) – Bond (50306)
- (1) Certification of Road Test Pocket Card (006-BC)
- (1) Driver Qualification and Identification Certificate Pocket Card (007-BC)
- (1) Medical Examination Certificate – Laminated Wallet Card (47379)
*Not sold separately
Volume Pricing
| Product Code | Description | 1 - 9 | 10 - 24 | 25 - 49 | 50 - 99 | 100 - 199 |
|---|---|---|---|---|---|---|
|
848
|
Two-Copy Forms Packet
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$14.08
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$11.36
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$9.88
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$8.67
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$6.99
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Specification
| Product Code | Description | Size | Units Per Case | Number of Plies | Format |
|---|---|---|---|---|---|
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848
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Two-Copy Forms Packet
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9.5" x 11.75"
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100 per case
|
1
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Folder
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