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

Overview

The OMB expiration of 8/31/18 has passed. In late September, the FMCSA indicated that only forms with the new 9/30/19 expiration date should be used. The FMCSA is expected to release another updated version of the medical exam forms, which could happen as soon as mid-November. Learn more and pre-order the updated forms with the 9/30/19 expiration date now.

• 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"

View Samples

View a sample Medical Examination Report.

View a sample Medical Examination Certificate - Laminated.

View a sample Medical Examiner's National Registry Verification.