Medical Examination Report, Certificate, & National Registry Verification – Retail Packaging (011643)
+ / - Hover over image to Zoom

Medical Examination Report, Certificate, & National Registry Verification – Retail Packaging

These forms will help you comply with 49 CFR §391.43. Read more.

$7.44
Product Code: 47999
List Price: $7.44
Add to Cart

Overview

  • Helps you comply with 49 CFR §391.43
  • The Medical Examination Report, Medical Examination Certificate/DOT Medical Card, and the Medical Examiner’s National Registry Verification are required by the DOT
  • Medical Examination Report - 47375 (761-F)
    • Complies with Final Rule published April 23, 2015
    • Helps you comply with 49 CFR §391.43
    • 9 pages long
    • Contains applicable regulations, instructions to the medical examiner, and the form itself
    • Measures 8-1/2" x 11"
  • Medical Examiner's Certificate - Laminated Paper Format (DOT Medical Card) - 47379
    • Complies with Final Rule published April 23, 2015
    • Helps you comply with 49 CFR §391.43
    • Self-laminating; front laminate protects the driver copy
    • Two plies
    • Tri-fold
    • Overall measurement 3-1/2" x 7-1/8", Certificate detached 3-1/2" x 6-1/2"
    • Folded measurement 3-1/2" x 2-3/16"
  • Medical Examiner’s National Registry Verification – 27034 (758-FS-C2)
    • Snap out format
    • Two plies
    • Carbonless
    • Complies with DOT's 49 CFR §391.23 and §391.51
    • Required to be used as of May 21, 2014
    • Measures 8-1/2" x 11-3/4"

Volume Pricing

Volume Pricing
Product Code Description 1 - 9 10 - 149 150 - 999999
47999
(1) Report, (1) Certificate, & (1) Verification Form
$7.44
$6.17
$5.54

Specification

Specification
Product Code Description Alternate Product Code Size
47999
(1) Report, (1) Certificate, & (1) Verification Form
019MP
6" x 10.5"

Related Solutions

Product Questions & Answers

Product Reviews