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How to use or fill out Bureau of Motor Vehicles - DRIVER MEDICAL EVALUATION
- Click ‘Get Form’ to open it in the editor.
- Begin by filling out your personal information in the 'THIS SECTION TO BE COMPLETED BY DRIVER' section. Include your name, date of birth, address, license/history number, and telephone number.
- Next, the appropriate medical or paramedical professional should complete the 'INFORMATION BELOW TO BE COMPLETED BY APPROPRIATE MEDICAL OR PARAMEDICAL PROFESSIONAL' section. This includes providing a reason for the report and any relevant functional ability profiles.
- In the 'DIAGNOSIS' section, ensure that all required fields are filled out accurately. Check one box per diagnosis and provide additional details as necessary.
- Clinicians should document any recommendations regarding restrictions or road tests in the 'CLINICIAN COMMENTS' section. Attach any additional documentation if needed.
- Finally, ensure that the clinician's signature and contact information are provided in the 'CERTIFICATE OF EXAMINATION' section before submitting the form.
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