Description
The Final Rule published April 20, 2012 requires the motor carrier to verify that the medical examiner was qualified to conduct a CDL driver’s physical exam. This form meets that requirement.
- Helps you comply with DOT’s 49 CFR §391.23 and §391.51
- Form can be used now, though it s required to be used as of May 21, 2014
- Includes fields to enter the following information:
- Driver’s Name and Identification Number
- Medical Examiner and National Registry Number
- Motor Carrier and Location
- Motor Carrier Representative Signature and Date
- Snap out format
- Two plies
- Carbonless
- Measures 8-1/2″ x 11-3/4″
