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PHYSICIAN S STATEMENT FOR MEDICAL REVIEW UNIT

PHYSICIAN S STATEMENT FOR MEDICAL REVIEW UNIT 2025

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The document is a Physician's Statement for the Medical Review Unit, intended for driver license customers to report medical, physical, or mental conditions. It requires completion by both the customer and their healthcare provider, ensuring that the information is based on a recent examination. The form collects personal details, treatment history, and assessments regarding the patient's ability to safely operate a motor vehicle.

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Versions	Form popularity	Fillable & printable
2022	4.8 Satisfied (59 Votes)
2015	4.9 Satisfied (50 Votes)
2013	4.4 Satisfied (62 Votes)

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Who might be asked to fill out a physicians statement driving?

Who needs the Physicians Statement of Examination for Driving? Individuals applying for a driving license who have health concerns. Physicians assessing a patients fitness to drive. Referring health care providers needing to submit a medical assessment.

Can you pass a DOT physical with seizures?

DOT interprets this regulation to permanently disqualify people with epilepsy regardless of present ability to control seizures. The regulations only cover truckers who cross state lines as part of their job and those who transport products within a state that originated in another state.

How do I submit my medical certificate to the DMV NY?

Contact Contact us by email: dmv.sm.cdlmedcertunit@dmv.ny.gov. Mailing Address: Medical Certification Unit. PO Box 2601. Albany, NY 12220-0601. Contact us by fax: 518-486-4421 or 518-486-3260.

Who reports seizures to DMV in NC?

North Carolina authorizes driver license examiners, driver license hearing officers, driver education specialists, law enforcement officers, court officials, physicians, or citizens to report drivers with certain illnesses such as epilepsy, which may make driving unadvisable, to the Division of Motor Vehicles for

Do doctors report seizures to DMV in NC?

However, after consulting with a patient, a physician may report a mental or physical condition that could impair the patients ability to safely operate a motor vehicle to the Commissioner of Motor Vehicles. Physicians who report such conditions in good faith are immune from civil or criminal liability. N.C. GEN.

Can you drive after being diagnosed with seizures?

To get a drivers license in most U.S. states, a person with epilepsy must be free of seizures that affect consciousness for a certain period of time. The seizure-free period varies from state to state. More recently, shorter intervals of seizure freedom are being required, for example 3 to 6 months.

What is the medical review program in NC?

The N.C. Division of Motor Vehicles Medical Review Unit Program evaluates drivers when there are concerns that certain medical conditions might have an impact on their ability to safely operate a vehicle.

Do doctors report seizures to DMV?

Doctors Reporting Seizures The specific conditions doctors must report vary between states. The most common reportable conditions are dementia, stroke, and progressive neurological illnesses. Doctors are only required to report epilepsy in six states: California.

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