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Get Dmv Physician Reporting Form California

Ver s License No. Date of Birth (MM/DD/YYYY) Patient s Name Last First Middle 1. Diagnosis: 2. In your opinion, will this medical condition affect the patient s ability to drive a vehicle safely? Yes* No Uncertain* *If Yes or Uncertain, please explain: 3. Status of Patient s Medical Condition(s)*: Improving Stable Worsening or Deteriorating Subject to Change *If multiple conditions exist, please describe status and prognosis. 4. How long has this person been your patient?.

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Contact support

Write us at reportfraud@dmv.ca.gov or call us! Northern California (916) 657-7742 or Southern California (626) 851-0173.

Call: 1-800-735-2929 using California Relay Telephone Service from TDD phones. 1-800-735-2922 from voice phones.

The most common way the DMV can learn about your epilepsy is from a report by your physician, particularly your neurologist. In California as in most states, doctors are obligated to report to the DMV any medical condition that can: lead to a lapse of consciousness or.

The Investigations Division diligently enforces laws, rules, and regulations that apply to new and used vehicle dealers, brokers, dismantlers, registrations services, vehicle verifiers, misuse of Disabled Person Parking Placard/Plates, driving schools or traffic violator schools, and other vehicle-related businesses.

Under California law, doctors are required to report anyone to the DMV who suffers from any medical or mental condition that may impact his/her ability to drive safely. Note that doctors themselves cannot directly revoke a driver's license.

Interacting with DMV has been made easier with the addition of Miles, the online chatbot, and a live chat option during business hours.

You can notify the California Highway Patrol of reckless driving incidents that are currently happening by calling 911. If the incident has already happened, you can call the non-emergency number at 800-TELLCHP.

The Drivers License or ID Card Application Also known as the DL 44 form, the application for a California drivers license or identification card is required when you apply for, renew, or replace your drivers license or ID card.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232