Medical exemption for ignition interlock device form 2026

1. Click ‘Get Form’ to open it in the editor.
2. In Section 1, complete all driver information including your driver license number, date of birth, name, and address. Indicate whether the IID requirement is from the court or DMV.
3. Provide the form to your health care provider for Section 2. They will need to fill in their details, including name, specialty, and contact information.
4. The health care provider must list the conditions that prevent you from operating an IID and confirm if the condition is permanent or temporary.
5. Once completed, submit the form to the appropriate agency (court or DMV). If approved, ensure you keep a copy of the exemption with your valid driver’s license while driving.

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