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The certificate allows a doctor to certify that an individual should not wear a seatbelt due to their medical condition.
The exemption from wearing a seatbelt is valid for a maximum period of 12 months from the date of issue.
The certificate must be carried by the driver if the person named in it is either driving or riding as a passenger in a vehicle fitted with a seatbelt.
The driver must present the certificate immediately to a police officer upon request.
The completed certificate does not need to be returned to the Department of Transport and Main Roads.
The medical condition assessment must comply with national medical standards as outlined in 'Assessing Fitness to Drive 2003'.
Information on this certificate is accessible by the Queensland Police Service, but not by the Department of Transport and Main Roads.