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Dmv customer medical report 2026

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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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See more dmv customer medical report versions

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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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