A DMV medical review request form is the document you file with your state’s motor vehicle agency to report a driver whose physical or mental condition may make them unsafe behind the wheel. Every state runs a version of this program, though the form’s name and layout differ by state. Filing it does not automatically take anyone’s license. It opens an investigation so the agency can decide whether restrictions, retesting, or a suspension are warranted.
Where to Get the Form
Start at your state DMV’s website. Most agencies post the form as a downloadable PDF under a section labeled “driver safety,” “medical review,” or “deteriorated driving skills.” The exact name varies. California uses Form DS 699. New York uses a DS-7. Many states simply call it a “Request for Driver Reexamination” or “Request for Driver Review.”
If you cannot find it online, call or visit your local DMV office and ask for the driver reexamination request form by name. Some states also accept a plain letter that provides the same information the form would collect, mailed to the Driver Safety or Medical Review office.
What Information the Form Asks For
The label changes from state to state, but the core fields are the same almost everywhere.1National Highway Traffic Safety Administration. Medical Review Practices for Driver Licensing Volume 3 – Guidelines and Processes in the United States
Identifying details about the driver come first. At minimum, provide the person’s full legal name and date of birth, or an approximate age if you don’t know the exact date. A driver’s license number helps the agency pull the right record quickly but is not usually required. A home address or vehicle license plate number, if you have either, also helps the agency locate the correct file.
The narrative section is the most important part of the form. Describe in specific, concrete terms why you believe the driver is no longer safe. Include dates, locations, and exactly what you observed. Not “seems confused sometimes,” but something like: “On March 12, drove through a red light at the intersection of Oak and Main without slowing; appeared unaware of cross traffic.” If you know the name of a diagnosed condition or a medication the driver is taking, include that too. Agencies decide whether to investigate based largely on how specific and credible this section is.
You will also provide your own identifying information: name, address, date of birth, phone number, and your relationship to the driver. Most states require your signature to authenticate the report. The form is not anonymous, though you can usually ask the agency to keep your identity from being disclosed to the driver.
Conditions Worth Reporting
Not every health issue warrants a report. The conditions that raise genuine driving safety concerns generally fall into a few categories, and knowing them helps you write a stronger narrative.2National Highway Traffic Safety Administration. Driver Fitness Medical Guidelines
- Seizure disorders. Epilepsy and other conditions involving lapses of consciousness are among the most common triggers. Most states require a seizure-free interval, ranging from three months to a year or more, before a person can drive.
- Cognitive decline. Dementia, Alzheimer’s disease, and traumatic brain injury can impair judgment, reaction time, and the ability to process road information.
- Vision problems. Glaucoma, macular degeneration, cataracts, and visual field loss all affect the ability to see hazards and read signs.
- Cardiovascular and metabolic conditions. Uncontrolled diabetes with a risk of hypoglycemia, heart conditions that cause fainting, and sleep apnea severe enough to cause drowsiness at the wheel.
- Physical impairments. Parkinson’s disease, multiple sclerosis, spinal cord injuries, and amputations that may require adaptive equipment or restrict the type of vehicle someone can safely operate.
- Medication side effects. Prescriptions that cause drowsiness, dizziness, blurred vision, or slowed coordination, even when the underlying condition is under control.1National Highway Traffic Safety Administration. Medical Review Practices for Driver Licensing Volume 3 – Guidelines and Processes in the United States
Temporary conditions like a broken leg or recovery from surgery can also prompt a review, though these cases typically resolve with a short-term restriction rather than a license action.
Where to Submit It
Completed forms generally go to a specific division, not your nearest field office. Most states operate a centralized Driver Safety Office or Medical Review Unit that handles these reports. The mailing address is usually printed on the form itself or on the agency’s website. Some states also accept fax submissions.
Send the form directly to the address or fax number listed rather than dropping it off at a general service counter, which can delay routing. If you want proof of delivery, use certified mail with a return receipt.
Processing times vary widely. Some agencies begin review within days. Others may take several weeks to open a case, depending on caseload and the severity of the reported condition. There is no universal timeline for confirming receipt.
Will the Driver Find Out You Filed It
This is often the biggest worry for someone reporting a family member. Most agencies allow you to request that your name not be disclosed to the driver being reported. No state can guarantee absolute confidentiality in every circumstance, since a court order could theoretically compel disclosure, but agencies honor confidentiality requests to the fullest extent possible as a matter of policy.
Many states also classify DMV records relating to a person’s physical or mental condition as confidential and closed to public inspection. The medical details in the file, and the report itself, are shielded from routine public records requests.
What Happens After You File
Once the agency opens a case, the investigation follows a predictable sequence. The specifics vary by state, but the framework is consistent nationwide.1National Highway Traffic Safety Administration. Medical Review Practices for Driver Licensing Volume 3 – Guidelines and Processes in the United States
The agency contacts the driver and sends a medical report form to be completed by a treating physician, meaning the doctor or specialist most familiar with the driver’s current health. The form asks the physician to describe the diagnosis, whether the condition is controlled, what medications the driver takes, and whether the physician believes the driver can operate a vehicle safely. The agency may also require the driver to complete a vision screening, a written knowledge test, or an on-road driving test.
A reviewer then weighs the physician’s report, any law enforcement records, the driver’s accident history, and your original complaint. Possible outcomes include:
- Case closed with no action, if the evidence shows the driver is fit.
- Continued driving with periodic medical reports at set intervals, such as every six months or annually.
- Driving with restrictions, such as daylight-only driving, no freeway driving, geographic radius limits, or required use of corrective lenses or adaptive equipment.
- Suspension or revocation, if the medical evidence shows a serious and uncontrolled risk.
When a law enforcement referral suggests immediate danger, some states use an expedited process that requires the driver to contact the agency within five working days or face automatic suspension. These accelerated reviews are reserved for cases where the risk is too high to wait for the standard timeline.
The driver has the right to participate throughout, submit their own medical evidence, and request a formal administrative hearing if the agency decides to suspend, revoke, or restrict the license. Filing the form starts a process; it does not decide the outcome.
Who Else Can File a Report
You do not need to be a medical expert or witness an accident to file. Family members, neighbors, caregivers, and anyone else with firsthand observations can submit a request, and the agency evaluates each case on its own merits regardless of who filed it.1National Highway Traffic Safety Administration. Medical Review Practices for Driver Licensing Volume 3 – Guidelines and Processes in the United States
Law enforcement forwards reports when a crash appears to have been caused by loss of consciousness, illness, or a physical or mental disability. Physicians can report as well. A handful of states, including California, Delaware, Nevada, New Jersey, Oregon, and Pennsylvania, legally require clinicians to report patients with specific conditions that affect driving.3JAMA Network. Confidentiality for Physicians Who Report Medically Impaired Drivers Reporting deadlines in those states can be as short as 24 hours. Everywhere else, physician reporting is voluntary, and most states offer legal immunity to doctors who report in good faith.