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Medical Examination Report, Certificate, & National Registry Verification

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

Product Code:47999
  • 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)
    • 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
    • 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
    • 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.

Size: 6" x 10.5"

Need to Purchase a Case?: 150 per case

Average Rating: 5.0

BVNumberOfReviews: 1

UNSPSC Number: Blank certificates - 60101602

Advantage Savings: Advantage Savings

Country Of Origin: USA