Product Information
Used by motor carriers to document the required verification that their medical examiners are qualified to conduct drivers' physical exams.
- Helps you comply with DOT's 49 CFR §391.23 and §391.51
- Use each time a commercial vehicle driver undergoes a DOT medical exam
- Includes fields to enter the following information:
- Driver's Name and Identification Number
- Certificate Expiration Date
- Medical Examiner and National Registry Number
- Motor Carrier and Location
- Motor Carrier Representative Signature and Date
- Padded format; 50 sheets per pad
- Single-ply
- Bond white paper
- Measures 8-1/2" x 11"
Specifications
Compliance Topic: Injury & Illness Recordkeeping, Driver Qualification & Hiring
Need to Purchase a Case?: 56 per case
Industry: Transportation, Human Resources
Average Rating: 5.0
BVNumberOfReviews: 2
Country Of Origin: USA
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