

Hero image 0 of DOT FMCSA Medical Examiner Certificate 5-pk. - Laminated, 2-Ply, Trifold, 3.5" x 7.125"- Commercial Driver Medical Certification to Comply w/ 49 CFR 391.43 DOT Medical Card Requirements- J. J. Keller, 0 of 5
DOT FMCSA Medical Examiner Certificate 5-pk. - Laminated, 2-Ply, Trifold, 3.5" x 7.125"- Commercial Driver Medical Certification to Comply w/ 49 CFR 391.43 DOT Medical Card Requirements- J. J. Keller
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Key item features
- Essential Compliance: This Medical Examiners Certificate is crucial for DOT compliance and commercial driving eligibility, meeting requirements under 49 CFR 391.43 for driver fitness evaluations.
- Compact Dimensions: The foldable wallet card measures 3-1/2" x 7-1/8" overall, 3-1/2" x 6-1/2" with the stub detached, and a compact 3-1/2" x 2-3/16" when tri-folded.
- Durable Construction: The medical exam card is 2-ply with a snap-out, self-laminating format designed to protect the driver's copy from wear and tear.
- Regulatory Adherence: Complies with FMCSA and OSHA regulations, specifically Form MCSA 5876, ensuring adherence to 49 CFR 391.43 standards.
- Convenient Packaging: Sold as a 5-pack, this set is suitable for medical examiners or employers managing multiple commercial drivers.
- Separate Documentation: The Medical Examination Report Form, which details the full medical evaluation, is a separate, mandatory document sold independently.
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Specs
- Standard form & application typeMedical Application Form
- Paper size3.5" x 7.125"
- Sheets5
- MaterialPaper
- Retail packagingPack
- Piece count5
Current price is USD$16.90
Price when purchased online
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Columbus, 43215
Arrives by Fri, Feb 6
|Sold and shipped by J. J. KELLER & ASSOCIATES, INC.|Pro Seller
4.549295774647887 stars out of 5, based on 71 seller reviews(4.5)71 seller reviews
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| Product | Viewing this itemDOT FMCSA Medical Examiner Certificate 5-pk. - Laminated, 2-Ply, Trifold, 3.5" x 7.125"- Commercial Driver Medical Certification to Comply w/ 49 CFR 391.43 DOT Medical Card Requirements- J. J. Keller ![]() $16.90 current price $16.90 | DOT Medical Examiner Certificate Folded Wallet Card 4x3.5 15 pk Truck Drivers Foldable Report Form 2-Ply Commercial Driver Comply 49 CFR Vehicle Inspection ![]() $24.99 current price $24.99 | Invoice Book 2-Part Carbonless Form Horizontal Sales Slip Features a Wraparound Cover 5-9/16 x 8-7/16 inches 50 Sets per Book(6 Pack) ![]() $15.96 current price $15.96 | 1099 and W-2 4up Blank TaxPack with NO printed instructions on back with Envelopes; 25 TaxPacks ![]() $18.99 current price $18.99 | Patient Sign-in Sheets, HIPAA Compliant, 8-1/2" x 11" Carbonless Form, Burgandy (Pack of 125) ![]() $94.44 current price $94.44 |
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| Standard form & application type | Medical Application FormDOT FMCSA Medical Examiner Certificate 5-pk. - Laminated, 2-Ply, Trifold, 3.5" x 7.125"- Commercial Driver Medical Certification to Comply w/ 49 CFR 391.43 DOT Medical Card Requirements- J. J. Keller | Medical Application FormDOT Medical Examiner Certificate Folded Wallet Card 4x3.5 15 pk Truck Drivers Foldable Report Form 2-Ply Commercial Driver Comply 49 CFR Vehicle Inspection | Receipt FormInvoice Book 2-Part Carbonless Form Horizontal Sales Slip Features a Wraparound Cover 5-9/16 x 8-7/16 inches 50 Sets per Book(6 Pack) | 1099-MISC Tax Forms1099 and W-2 4up Blank TaxPack with NO printed instructions on back with Envelopes; 25 TaxPacks | -Patient Sign-in Sheets, HIPAA Compliant, 8-1/2" x 11" Carbonless Form, Burgandy (Pack of 125) |
|---|---|---|---|---|---|
| Paper size | 3.5" x 7.125"DOT FMCSA Medical Examiner Certificate 5-pk. - Laminated, 2-Ply, Trifold, 3.5" x 7.125"- Commercial Driver Medical Certification to Comply w/ 49 CFR 391.43 DOT Medical Card Requirements- J. J. Keller | 4x3.5DOT Medical Examiner Certificate Folded Wallet Card 4x3.5 15 pk Truck Drivers Foldable Report Form 2-Ply Commercial Driver Comply 49 CFR Vehicle Inspection | 5-9/16 x 8-7/16 inchInvoice Book 2-Part Carbonless Form Horizontal Sales Slip Features a Wraparound Cover 5-9/16 x 8-7/16 inches 50 Sets per Book(6 Pack) | Letter1099 and W-2 4up Blank TaxPack with NO printed instructions on back with Envelopes; 25 TaxPacks | 8-1/2" x 11"Patient Sign-in Sheets, HIPAA Compliant, 8-1/2" x 11" Carbonless Form, Burgandy (Pack of 125) |
| Sheets | 5DOT FMCSA Medical Examiner Certificate 5-pk. - Laminated, 2-Ply, Trifold, 3.5" x 7.125"- Commercial Driver Medical Certification to Comply w/ 49 CFR 391.43 DOT Medical Card Requirements- J. J. Keller | 15DOT Medical Examiner Certificate Folded Wallet Card 4x3.5 15 pk Truck Drivers Foldable Report Form 2-Ply Commercial Driver Comply 49 CFR Vehicle Inspection | 100Invoice Book 2-Part Carbonless Form Horizontal Sales Slip Features a Wraparound Cover 5-9/16 x 8-7/16 inches 50 Sets per Book(6 Pack) | 101099 and W-2 4up Blank TaxPack with NO printed instructions on back with Envelopes; 25 TaxPacks | 125Patient Sign-in Sheets, HIPAA Compliant, 8-1/2" x 11" Carbonless Form, Burgandy (Pack of 125) |
| Material | PaperDOT FMCSA Medical Examiner Certificate 5-pk. - Laminated, 2-Ply, Trifold, 3.5" x 7.125"- Commercial Driver Medical Certification to Comply w/ 49 CFR 391.43 DOT Medical Card Requirements- J. J. Keller | -DOT Medical Examiner Certificate Folded Wallet Card 4x3.5 15 pk Truck Drivers Foldable Report Form 2-Ply Commercial Driver Comply 49 CFR Vehicle Inspection | Carbonless PaperInvoice Book 2-Part Carbonless Form Horizontal Sales Slip Features a Wraparound Cover 5-9/16 x 8-7/16 inches 50 Sets per Book(6 Pack) | Paper1099 and W-2 4up Blank TaxPack with NO printed instructions on back with Envelopes; 25 TaxPacks | -Patient Sign-in Sheets, HIPAA Compliant, 8-1/2" x 11" Carbonless Form, Burgandy (Pack of 125) |
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About this item
Product details
Complies with OSHA 49 CFR 391.43 - Stay in compliance with FMCSA regulations using this Medical Examination Certificate (Form MCSA 5876), as required under 49 CFR 391.43 for commercial driver fitness evaluations. DOT Required Certificate– Medical Examiner’s Certificate is essential for DOT compliance and commercial driving eligibility. Foldable Wallet Card: DOT medical card overall measures 3-1/2" x 7-1/8". With stub detached, it measures 3-1/2" x 6-1/2". Tri-folded measurement is 3-1/2" x 2-3/16". The medical examiner certificate can be stored in a document holder or tri-folded and stored in a wallet. Ensure compliance with OSHA and FMCSA regulations by using this Medical Examination Certificate (Form MCSA 5876), which fulfills the requirements under 49 CFR 391.43 for commercial driver fitness evaluations. This DOT-required Medical Examiner’s Certificate is a crucial document for maintaining DOT compliance and verifying a driver’s eligibility to operate commercial motor vehicles. Designed as a foldable wallet card, the DOT medical card measures 3-1/2" x 7-1/8" when fully opened, providing ample space for necessary information. With the stub detached, the card measures 3-1/2" x 6-1/2", and when tri-folded, it compacts neatly to 3-1/2" x 2-3/16", making it easy to carry in a wallet or store in a document holder. This thoughtful design allows drivers to keep their certification accessible and protected at all times. The medical exam card is constructed with 2-ply cardstock and features a snap-out, self-laminating format that safeguards the driver’s copy from wear and tear, ensuring durability and longevity. Each pack contains five certificates, ideal for medical examiners or employers managing a small group of commercial drivers. It is important to note that the Medical Examination Report Form, which documents the full medical evaluation, and the Medical Exam Certificate/DOT Medical Card are both mandatory documents required by the DOT. The Medical Examination Report Form is sold separately, so be sure to obtain it to maintain complete compliance with federal regulations. This Medical Examiner’s Certificate offers a practical, professional solution for medical examiners and drivers alike to meet all FMCSA and OSHA standards efficiently and reliably.
- DOT Required Certificate– Medical Examiner’s Certificate is essential for DOT compliance and commercial driving eligibility.
- Foldable Wallet Card: DOT medical card overall measures 3-1/2" x 7-1/8". With stub detached, it measures 3-1/2" x 6-1/2". Tri-folded measurement is 3-1/2" x 2-3/16". The medical examiner certificate can be stored in a document holder or tri-folded and stored in a wallet.
- Medical exam card is 2-ply with a snap-out, self-laminating format to protect the driver copy. Sold as a 5 pack.
- Note: Medical Examination Report Form and Medical Exam Certificate/DOT Medical Card are required by the DOT. DOT medical exam form sold separately.
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Specifications
Standard form & application type
Medical Application Form
Paper size
3.5" x 7.125"
Brand
J. J. Keller & Associates, Inc.
Sheets
5
Warranty
Warranty information
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