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Medical Examination Certificate - Small (011709)
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Medical Examination Certificate - Small

Helps you comply with 49 CFR §391.43 DOT medical card requirements. Read more.

Product Code: 47377
List Price: $1.74
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Overview

NOTICE: The latest Medical Examiner’s Certificates show an OMB expiration date of 9/30/2019 in the upper-right corner. On Oct. 18, 2018, in a change of position, the Federal Motor Carrier Safety Administration (FMCSA) announced that older certificates are still acceptable. 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.


  • Helps you comply with 49 CFR §391.43
  • Two plies
  • Measures 4-1/4” x 5-1/4”
  • Both the Medical Examination Report and Medical Examination Certificate/DOT Medical Card are required by the DOT

Volume Pricing

Volume Pricing
Product Code Description 1 - 9 10 - 49 50 - 99 100 - 249 250 - 499
47377
Small
$1.74
$1.63
$0.86
$0.81
$0.67

Specification

Specification
Product Code Description Format Size Carbon Type Number of Plies Units Per Case
47377
Small
Snap-out
4.25" x 5.25"
Carbonless
2
2,300 per case

View Sample

View a sample Medical Examination Certificate - Small.

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