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Use this form to request medical information from your physician, physician assistant or nurse practitioner

Use this form to request medical information from your physician, physician assistant or nurse practitioner 2025

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The MED 2 document is a Customer Medical Report form used to request medical information from healthcare providers regarding an individual's ability to safely operate a motor vehicle. It includes sections for customer information, medical history, and specific medical evaluations related to neurological, metabolic, cardiovascular, pulmonary, and psychiatric conditions. The form must be completed by a licensed medical provider and submitted to the DMV to assess the individual's driving capabilities, especially in light of any medical conditions or incidents that may affect their ability to drive safely.

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Click ‘Get Form’ to open it in the editor.
Begin by filling out the 'Customer Information' section. Enter your name, customer number or SSN, address, birth date, and contact details accurately.
In the 'Medical Condition' section, provide a detailed description of your medical condition and any medications you are taking. Be sure to indicate if you have experienced any significant episodes like 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.
Once completed, take the entire MED 2 form along with your DMV letter to your healthcare provider for them to fill out their sections.

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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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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

Do you have to tell California DMV if you have diabetes?

It depends. DMV might need additional medical information when you apply for or renew your DL and indicate that you have diabetes.

What is the medical evaluation form for California DMV?

The Form DS-326, also known as a Driver Medical Evaluation (DME), is a form prepared by the DMV that is provided to medical professionals for the purpose of documenting a drivers physical or mental health.

What is a DS 6 physician reporting form?

The DMV DS-6 Form, known as the Physicians Reporting Form, is an essential document for physicians or nurse practitioners to report individuals whose ability to drive may be compromised due to physical or mental impairments.

Can a doctor tell you you cant drive?

Under California law, doctors are required to report you to the DMV if you suffer from any medical or mental condition that may impact your ability to drive safely. Note that doctors themselves cannot directly revoke your drivers license.

How do I submit my medical certificate to the DMV NY?

Contact Contact us by email: dmv.sm.cdlmedcertunit@dmv.ny.gov. Mailing Address: Medical Certification Unit. PO Box 2601. Albany, NY 12220-0601. Contact us by fax: 518-486-4421 or 518-486-3260.