JJ KELLER part 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"

JJ Keller® is an industry expert in safety and compliance. It provides organizations of all sizes with the right tools and expert advice to create productive, safe, and compliant workplaces. While it does offer managed and consulting services regarding safety and compliance for DOT regulations, it also supplies a wide range of training materials and tools and a comprehensive list of digital and printed publications, forms, and supplies. DOT compliance for fleets has never been easy with JJ Keller. Its wide assortment of decals, placards, and flags helps keep employees and drivers safe and in compliance while on the job.

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