Medical Examination Report, Certificate, & National Registry Verification
These forms will help you comply with 49 CFR §391.43.
- 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