U N I T Y F R E I G H T
Application Form 3

Medical Examiner's National Registry Verification

MOTOR CARRIER INSTRUCTIONS: The requirement to include verification of the medical examiner's National Registry listing in the driver's qualification files was published in the Federal Register April 20, 2012. Beginning May 21, 2014, motor carriers must certify that the medical examiner who signed the driver's medical card is listed on the National Registry. This requirements is prescribed in §391.23 and §391.51.

§391.23 investigation and inquiries. (m)(1) The motor carrier must obtain an original or copy of the medical examiner's certificate issued in accordance with §391.43, and any medical variance on which the certification is based, and, beginning on or after May 21, 2014, verify the driver was certified by an medical examiner listed on the National Registry of Certified Medical Examiners as of the date of issuance of the medical examiner's certificate, and place the records in the driver qualifications file, before allowing the driver to operate a CMV. (§391.23(m)(L))

§391.51 General requirements for driver qualification files. (b)(9)A note relating to verification of medical examiner listing on the National Registry of Certified Medical Examiners required by §391.23(m). (§391.51(b)(9))

Motor Carrier Verification: The following medical examiner has been verified as being listed on the National Registry of Certified Medical Examiners as of the date of issuance of the medical examiner's certificate for the named driver

(Motor Carrier Representative Signature)
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