Temporarily on backorder. Expected availability 5/1/2025 (subject to change). Orders for this item will ship as soon as it becomes available.

Regulatory Alert: Effective April 1, 2025 The FMCSA has reissued its Medical Examiner’s Certificate and Medical Examination Report Form with a new OMB expiration date of “3/31/2028” in the upper right corner and a revision (rev) date of “3/27/25” in the lower right corner. The FMCSA is allowing medical examiners to use up their existing stock of older forms. FMCSA is encouraging, but not requiring, state licensing agencies to continue accepting them. 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
• Unlaminated
• Two plies
• Tri-fold
• Overall measurement 3-1/2" x 7-1/8". Certificate detached is 3-1/2" x 6-1/2"
• Folded measurement 3-1/2" x 2-3/16"
• Both the Medical Examination Report and Medical Examiner's Certificate are required by DOT