Three N.C. congressmen have joined 35 Republican colleagues signing on to a letter asking President Biden to take a cognitive test.

“We again write to you to express concern with your current cognitive state,” reads the letter sent Tuesday to the 79-year-old Biden. Its author, Rep. Ronny Jackson, R-Texas, served both Barack Obama and Donald Trump as physician to the president from 2013 to 2018.

Among the letter’s 37 co-signers are North Carolina’s Rep. Greg Murphy, R-3rd District; Rep. David Rouzer, R-7th District; and Rep. Madison Cawthorn, R-11th District. Like the letter’s author, Murphy is a medical doctor.

“We believe that, regardless of gender, age, or political party, all Presidents should follow the example set by former President Trump to document and demonstrate sound mental abilities,” according to the letter. “While you underwent your annual physical exam on November 19, 2021, you either did not have a cognitive test or those results were withheld from the public.”

“White House Physician Kevin O’Connor, D.O., attested to you being ‘fit to successfully execute the duties of the Presidency’ in a purely physical manner; however, we are worried about your cognitive and mental abilities,” the letter continued.

Several members of Congress sent Biden a similar letter last June. He never answered their request. “Since then, the American people have continuously lost faith in your ability to effectively and competently handle your duties as President of the United States,” according to this week’s letter.

Polling data suggest public concern about Biden’s mental health, the letter contends. Among the cited findings: 48% of voters “disagree with the statement that you are mentally fit.”

“Independents, by a margin of 23 points, do not believe you are mentally fit,” according to the letter.

Jackson’s letter cites recent examples of Biden publicly insulting a reporter with an expletive and struggling to read numbers during a press conference. Both incidents could point to signs of mental decline.

“This is not just a recent trend, as your mental decline and forgetfulness have become more apparent over the past two years,” the letter argues. “On the campaign trail, you often forgot the names of states that you were in for campaign rallies.”

“The American people should have absolute confidence in their President,” Jackson adds. “They deserve to know that he or she can perform the duties of Head of State and Commander-in-Chief. They deserve full transparency on the mental capabilities of their highest elected leader. To achieve this, we urge you to submit to a cognitive test immediately. We implore you to then publish the test results, so the American people know the full mental and intellectual health of their President, and to follow the example set before you.”

The letter notes that in 2018 “political opponents and members of the media clamored” for Trump to take the same type of test. Trump complied and took a test, “at which he excelled.”

Copied on the letter to Biden are O’Connor and Dr. Anthony Fauci, who is listed as Biden’s chief medical adviser.