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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 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
| Product Code | Description | 1 - 9 | 10 - 49 | 50 - 99 | 100 - 249 | 250 - 499 |
|---|---|---|---|---|---|---|
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47377
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Small
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$1.74
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$1.63
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$0.86
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$0.81
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$0.67
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Specification
| Product Code | Description | Format | Size | Carbon Type | Number of Plies | Units Per Case |
|---|---|---|---|---|---|---|
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47377
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Small
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Snap-out
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4.25" x 5.25"
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Carbonless
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2
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2,300 per case
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