Medical Examiners Certificate 2 Part Form

The Expiration Date on this MCSA-5876 Medical Examiners Certificate is 11/30/2021.

The Medical Examiner's Certificate is required to be carried by every driver of a commercial motor vehicle as proof of medical qualification per 49 CFR 391.41. 

The 3.5" x 4" medical examiner's certificate folds to business card size and is easy to transport and carry, given it's wallet size. The top ply is paper and the bottom ply is cardstock.

The Medical Examiners Certificate includes:

• Signature of Driver
• Telephone
• Date Signed
• Medical Examiners Name
• Physician Type
• License Number
• Registration Number
• Certificate Number
• Issuing State
• Signature of Driver
• Drivers License Number
• Issuing State
• Address of Driver
• Certificate Expiration Date
• More
  

These Forms are always up-to-date with the latest FMCSA revisions.

Questions about revisions? Inquire here.