M107a 2026

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The document is a Medical Assessment Certificate from the Government of Western Australia, specifically for evaluating an individual's fitness to drive. It outlines the process for applicants and health professionals, including consent for information sharing, details required from the applicant, and assessment criteria to determine if the individual meets medical standards for driving. The form must be completed by a health professional and submitted to the Department of Transport.

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Click ‘Get Form’ to open the m107a in the editor.
Begin by filling out the 'Applicant details' section. Enter your family name, given names, date of birth, and residential address. Ensure all information is accurate.
In the 'Licence details' section, circle the classes of vehicles you are currently authorized to drive or wish to apply for. This includes options like motor cars, motorcycles, and various rigid vehicle classes.
Complete the 'Driver’s Licence / Permit No' and 'Expiry Date' fields accurately. Indicate any medical conditions or medications in the designated areas.
If you are a health professional completing the assessment section, answer all questions regarding the patient's medical history and clinical findings thoroughly.
Finally, review all entries for accuracy before submitting via email or fax as instructed at the top of the form.

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Versions	Form popularity	Fillable & printable
2020	4.2 Satisfied (33 Votes)
2016	4.9 Satisfied (55 Votes)
2014	4 Satisfied (45 Votes)

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