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J. J. Keller protects people and the businesses they run. You can trust our expertise across a wide range of subjects relating to labor, transportation, environmental, and worker safety. Our deep knowledge of federal and state agencies is built on a strong foundation of more than 100 editors and consultants and 70+ years of regulatory compliance experience.

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J. J. Keller protects people and the businesses they run. You can trust our expertise across a wide range of subjects relating to labor, transportation, environmental, and worker safety. Our deep knowledge of federal and state agencies is built on a strong foundation of more than 100 editors and consultants and 70+ years of regulatory compliance experience.

Medical Examination Certificate, Unlaminated - Snap-Out, 2-Ply, Carbon, 3-1/2" W x 7-1/8" L

Helps you comply with 49 CFR §391.43 DOT medical card requirements.

Product Code:67602
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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

Material: Unlaminate
Unlaminate
Laminate

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
  • Laminated or Unlaminated
  • 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"
  • 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 - Laminated.

Carbon Type: Carbon

Number of Plies: 2

Compliance Topic: Injury & Illness Recordkeeping, Driver Qualification & Hiring

Size: Ply 1 - 3.5" x 7.125", Ply 2 - 3.5" x 7.125"

Format: Snap-out

Country Of Origin: USA

Need to Purchase a Case?: 500

Industry: Human Resources, Transportation

Average Rating: 4.3, 4.5, 4.4

BVNumberOfReviews: 23, 25, 26, 27, 24

Advantage Savings: Advantage Savings