Jj Keller 27033 - Medical Examiners National Registry Verification 50 Sheet Padded Form Book

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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 Padded format; 50 sheets per pad Single-ply Bond white paper Measures 8-1/2" x 11".

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