Close
Medical Examination Certificate - Small
Helps you comply with 49 CFR §391.43 DOT medical card requirements. Read more.
Regulatory Alert: Effective January 16, 2024, the FMCSA revised its Medical Examiner’s Certificate and Medical Examination Report Form to remove an obsolete reference. Learn More
Product Code:
47377
Best Selling Driver Qualification Forms
Medical Examination Certificate
Helps you comply with 49 CFR §391.43 DOT medical card requirements.
(23)
Medical Examination Report Form
Helps you comply with 49 CFR §391.43 DOT medical card requirements.
(6)
Medical Examination Certificate - Small
Helps you comply with 49 CFR §391.43 DOT medical card requirements.
(2)
Overview
Regulatory Alert: Effective January 16, 2024
The FMCSA revised its Medical Examiner’s Certificate and Medical Examination Report Form to remove an obsolete reference. The new forms may be identified by a revision (rev) date, respectively, of “3/1/23” and “2/28/2023” in the lower corner (the date in the upper corner remains 3/31/2025). The FMCSA is allowing medical examiners to use up their existing stock of older forms, and is encouraging state licensing agencies to continue accepting them, beyond the January 16 deadline. However, motor carriers and medical examiners are advised to switch to the new forms as soon as possible.
- 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 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Higher quantities available. Pricing reflected in shopping cart or call 1-877-564-2333 to order. | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
47377
|
Small
|
$2.46
|
$2.30
|
$1.23
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Specification
| Product Code | Description | Carbon Type | Format | Number of Plies | Size | Need to Purchase a Case? | Country Of Origin |
|---|---|---|---|---|---|---|---|
|
47377
|
Small
|
Carbonless
|
Snap-out
|
2
|
4.25" x 5.25"
|
2,300 per case
|
USA
|
;){kind=link}