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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.
(13)
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Medical Examination Certificate - SmallHelps you comply with 49 CFR §391.43 DOT medical card requirements.
(1)
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Medical Examination Report FormHelps you comply with 49 CFR §391.43 DOT medical card requirements.
(2)
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Overview
NOTICE: The latest Medical Examiner’s Certificates show an OMB expiration date of 11/30/2021 in the upper-right corner. On Dec. 4, 2018, the Federal Motor Carrier Safety Administration (FMCSA) informed us that there is no specific deadline when forms dated 8/31/2018 or 9/30/2019 can no longer be used, though they do “suggest” that the 2019 or 2021 versions be used in place of the 2018 version. The FMCSA also announced that it “is encouraging the State Driver's Licensing Agencies (SDLAs) to accept these forms with expiration dates of 08/31/2018, 09/30/2019, and 11/30/2021.” Therefore, all three versions remain acceptable but upgrading to the 2019 or 2021 versions is advised.
- Helps you comply with 49 CFR §391.43
- Two plies
- Measures 5-2/3” x 9-7/8”
- Both the Medical Examination Report and Medical Examination Certificate/DOT Medical Card are required by the DOT
Volume Pricing
| Product Code | Description | 1 - 9 | 10 - 49 | 50 - 99 | 100 - 249 | 250 - 499 |
|---|---|---|---|---|---|---|
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47376
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Large
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$1.88
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$1.69
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$0.89
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$0.83
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$0.69
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Specification
| Product Code | Description | Size | Carbon Type | Format | Number of Plies | Units Per Case |
|---|---|---|---|---|---|---|
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47376
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Large
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5.67" x 9.875"
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Carbonless
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Snap-out
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2
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1,200 per case
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