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A Medical Review Request is a form used to request the Department of Motor Vehicles (DMV) to conduct a medical review of a licensed driver. This form is critical in ensuring that drivers who have medical conditions affecting their ability to operate a vehicle safely are assessed appropriately. It includes sections capturing driver and requester information, details about the required medical examinations, and a description of circumstances that underline the need for such a review. Its main purpose is to maintain road safety by evaluating and determining whether individuals with certain medical conditions should continue to hold a driver's license.
Completing the Medical Review Request involves several important steps:
Gather Necessary Information: Collect all pertinent details about the driver, including full name, driver’s license number, and contact information. Additionally, gather your own information as the requester, if applicable.
Detail Required Examinations: Clearly specify the type of medical examination(s) required. This might include vision tests, neurological evaluations, or other relevant assessments deemed necessary.
Describe Circumstances: Provide a comprehensive description of the incidents or behaviors observed that suggest the need for a medical review. This should be detailed and objective to aid in the DMV's assessment.
Completeness & Verification: Ensure all sections of the form are filled out completely and correctly. Verify the information to avoid any errors that could delay processing.
The Medical Review Request form can typically be obtained through several methods depending on the state’s DMV procedures:
Online Download: Visit the official DMV website for your state, where most forms can be downloaded directly as a PDF.
DMV Office: You may visit a local DMV office to request a physical copy of the form.
Mail Request: Some DMVs offer the option to request forms by mail. This may involve a waiting period for processing and delivery.
The Medical Review Request should be used when there is reasonable concern that a licensed driver’s medical condition may impair their ability to drive safely. Such circumstances can include:
Using the Medical Review Request responsibly is important to ensure compliance with legal and ethical standards:
Confidential Information: Protect the privacy of the individual by handling their medical information with care.
Accurate Representation: Ensure all details submitted are truthful and can be substantiated with evidence if required.
Legal Implications: Understand that false reporting can lead to legal consequences, including penalties for obstruction or misconduct.
The rules and procedures concerning Medical Review Requests vary from state to state within the United States.
Specific Criteria: Some states have unique criteria for when a medical review is mandatory.
Process Variations: The processing times and review procedures may differ based on state regulations and resources.
Additional Requirements: Certain states might require further documentation or medical endorsements from healthcare providers.
This form includes several critical sections:
Driver Information: Name, contact details, and driver's license number.
Requester Details: Name and contact information of the individual submitting the request.
Examination Types: Clear specification of required medical evaluations.
Circumstantial Evidence: Detailed account of incidents leading to the review request.
Submitting the Medical Review Request can usually be done through different channels:
Mail: Most common method. Include all necessary documents and send them to the designated DMV address.
In-Person: Deliver the form to a local DMV office for immediate processing assistance.
Fax or Online: Some states may offer online submission portals or designated fax numbers for faster processing.
Understanding who can submit a Medical Review Request is necessary for compliance:
Public Authority: Typically, law enforcement or healthcare professionals can submit requests based on formal observations related to road safety.
Family Members: In several states, close family members may also request a medical review if they have valid concerns about the driver’s ability.


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