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Dmv customer medical report 2025

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The MED 2 document is a Customer Medical Report form used to request medical information from healthcare providers for individuals seeking to demonstrate their ability to safely operate a motor vehicle. It includes sections for customer information, medical history, and specific health assessments related to neurological, metabolic, cardiovascular, pulmonary, and psychiatric conditions. The form must be completed by a licensed medical provider and submitted to the Department of Motor Vehicles (DMV) as part of the process to address concerns about the individual's driving capabilities.

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Click ‘Get Form’ to open the DMV Customer Medical Report in our editor.
Begin by filling out the 'Customer Information' section. Enter your name, address, customer number or SSN, birth date, gender, weight, height, and daytime telephone number.
In the 'Medical Condition' section, provide a detailed description of your medical condition and any medications you take. Be sure to indicate if you've experienced blackouts or seizures.
Complete the 'Information Release Approval' section by authorizing your medical provider to fill out the necessary parts of the form. Don’t forget to sign and date this section.
Take the completed form along with your DMV letter to your physician for them to fill out relevant sections regarding your medical condition.

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Versions	Form popularity	Fillable & printable
2023	4.5 Satisfied (39 Votes)
2020	4.8 Satisfied (128 Votes)
2020	4.3 Satisfied (110 Votes)
2017	4.3 Satisfied (158 Votes)
2016	4.3 Satisfied (46 Votes)
2013	4.2 Satisfied (61 Votes)
2011	4 Satisfied (50 Votes)

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

Who reports seizures to DMV in Georgia?

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.

What medical condition keeps you from driving?

Some neurological conditions, including Parkinsons disease and multiple sclerosis, can affect your nervous system and driving abilities. Strokes and transient ischemic attacks (TIAs) can also affect your ability to operate a motor vehicle.

Do doctors report seizures to DMV PA?

83.4(a) states that a person who has a seizure disorder will not be qualified to drive unless a licensed physician reports that the person has been free from seizure for at least 6 months immediately preceding, with or without medication.

How do I get my license back after medical suspension in PA?

Steps You Must Take to Restore Your License Surrender your license. You do not start earning credit for your suspension until you surrender your current license, drivers permit, or photo ID. Request a restoration requirements letter. Follow your restoration requirements.

What to expect when my medical condition has been reported to PennDOT?

PennDOT will review the information it has received and may contact you to obtain further information. Based on all the information submitted, PennDOT makes the decision to place restrictions on the persons driving, recall the license, ask the person to complete a drivers examination or no action may be taken.

florida dmv medical review form

DMV Medical Review Services phone number Virginia DMV Medical Review phone NUMBER NYS DMV Medical Review Unit phone number How long does NYS DMV medical review take dmv medical review unit albany, ny DMV Medical Review form DMV medical Review request form NY DMV Medical Review Unit

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What is the medical evaluation form for California DMV?

The Form DS-326, also known as a Driver Medical Evaluation (DME), is a form prepared by the DMV that is provided to medical professionals for the purpose of documenting a drivers physical or mental health.

At what weight do you need a medical card in PA?

In Pennsylvania, a DOT medical card is required for any commercial driver who operates a vehicle with a gross weight of 10,000 pounds or more or transports hazardous materials.

Dmv customer medical report 2025

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How to use or fill out DMV Customer Medical Report with DocHub

See more dmv customer medical report versions

Complete this form in 5 minutes or less

Got questions?

Who reports seizures to DMV in Georgia?

What medical condition keeps you from driving?

Do doctors report seizures to DMV PA?

How do I get my license back after medical suspension in PA?

What to expect when my medical condition has been reported to PennDOT?

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What is the medical evaluation form for California DMV?

At what weight do you need a medical card in PA?

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