Driver examination and or medical evaluation request - NJ 2026

1. Click ‘Get Form’ to open the driver examination and/or medical evaluation request in the editor.
2. Begin by entering the driver's license number and class in the designated fields. This information is crucial for identifying the driver in question.
3. Fill in the driver's date of birth, ensuring accuracy as this will be used for verification purposes.
4. Complete the personal details section, including name, address, city/state/zip, sex, eye color, height, and issue date. Each field must be filled out clearly to avoid any processing delays.
5. Indicate if there are any reasons for reexamination by checking applicable boxes related to mental or physical disorders, traffic accidents, point accumulation, or convictions.
6. In the narrative section at the end of the form, provide a detailed explanation of why you believe a reexamination is necessary. Include any relevant observations or contacts with the driver.

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