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Wa dol physical examination report

Wa dol physical examination report 2026

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The document is a Physical Examination Report form used to assess a driver's ability to safely operate a motor vehicle. It requires the driver to provide personal information and consent for a medical examiner to report on their medical condition. The medical examiner must evaluate any conditions that may affect driving safety and submit the completed form to the Department of Licensing in Washington State.

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Click ‘Get Form’ to open the wa dol physical examination report in the editor.
Begin by filling out the Driver section. Enter your name, date of birth, and contact numbers. Ensure you provide your driver license number and today's date.
Sign the consent to release information, authorizing a licensed medical professional to share your medical condition details from an examination conducted within the last three months.
If applicable, have a parent sign in the designated area if you are a minor.
Next, the medical examiner should complete their section. They will answer questions regarding any conditions that may affect driving ability and provide their professional details.
Once all sections are completed, review for accuracy before printing or saving your document.

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Versions	Form popularity	Fillable & printable
2019	4.7 Satisfied (32 Votes)
2011	4 Satisfied (37 Votes)

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