Medical Examination Certificate, Large - Snap-Out, 2-Ply, Carbonless, 5-2/3" W x 9-7/8" L
Helps you comply with 49 CFR ยง391.43 DOT medical card requirements.
Regulatory Alert: Effective January 16, 2024,
The FMCSA revised its Medical Examinerโs Certificate and Medical Examination Report Form to remove an obsolete reference. The new forms may be identified by a revision (rev) date, respectively, of โ3/1/23โ and โ2/28/2023โ 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 ยง391.43
- Two plies
- Measures 5-2/3โ x 9-7/8โ
- Both the Medical Examination Report and Medical Examination Certificate/DOT Medical Card are required by the DOT
View Sample
View a sample Medical Examination Certificate - Large.
Carbon Type: Carbonless
Number of Plies: 2
Compliance Topic: Driver Qualification & Hiring, Injury & Illness Recordkeeping
Size: 5.67" x 9.875"
Format: Snap-out
Need to Purchase a Case?: 1,200 per case
Industry: Human Resources, Transportation
Average Rating: 5.0
BVNumberOfReviews: 2
UNSPSC Number: Examination booklets or forms - 14111533
Advantage Savings: Advantage Savings
Country Of Origin: USA