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Dmv physician reporting form california seizure

Dmv medical evaluation form 2026

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46 votes

The document is a Driver Medical Evaluation form used by the California Department of Motor Vehicles (DMV) to assess a driver's medical fitness to operate a vehicle. It includes instructions for both the driver and their medical professional, requiring detailed health history and evaluations related to various medical conditions that may impact driving safety. The form emphasizes confidentiality of medical information and outlines the responsibilities of both parties in providing accurate health assessments.

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Click ‘Get Form’ to open the DMV Medical Evaluation form in the editor.
Begin by filling out Section 1, which includes your personal information such as name, address, and driver license number. Ensure all details are printed legibly.
In Section 1, answer the health history questions honestly. If you answer 'YES' to any question, provide a detailed explanation in the space provided.
Proceed to Section 2 and read the advisory statement carefully. This section outlines the importance of providing accurate medical information.
Complete Section 3 by authorizing your medical professional to share relevant health information with the DMV. Sign and date this section.
Once you have completed Sections 1-3, print the form and take it to your medical professional for them to fill out Sections 5-13.

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Versions	Form popularity	Fillable & printable
2020	4.9 Satisfied (46 Votes)
2010	4.2 Satisfied (53 Votes)

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