Get Diz1

Filling out the Diz1 form online is a straightforward process that requires accurate and detailed information about your medical history and current health status. This guide will help you navigate through each section of the form to ensure you provide all necessary information correctly.

Follow the steps to effectively complete the Diz1 form online.

1. Click ‘Get Form’ button to obtain the Diz1 form and open it in the designated editor.
2. Part A: About you - Fill out your title, surname, date of birth, first name(s), driver number, address, telephone numbers (home and mobile), postcode, and email. Ensure all information is written in block capital letters using black ink.
3. Part B: About your GP and your consultant - Provide your GP's name and address, along with your consultant's name and address. Include their respective telephone numbers, dates when last seen, and email addresses (if known). If you have multiple consultants, list their details on a separate sheet.
4. Part C: Other clinics - List any additional clinics you are attending, including the name of the clinic, reason for attendance, date seen, and reference number.
5. Questionnaire section: Answer the questions regarding your medical fitness to drive. Respond to each item concerning any dizziness or related conditions, indicating whether it has been experienced in the past 12 months. If applicable, provide details about medication and the control of symptoms.
6. Consent section - Read and understand the consent information. Sign and date the declaration, indicating your authorizations regarding the release of medical information. Ensure to answer yes or no to the questions about communication preferences.
7. Finalize the form by reviewing all sections for accuracy. Once completed, users can save changes, download, print, or share the form as needed.

Complete your Diz1 form online today for a seamless submission process.