Get Medical Certification Form

Filling out the Medical Certification Form online is a crucial step for applicants seeking a TLC Driver's License in New York City. This guide provides comprehensive instructions to help users navigate the form with ease and accuracy.

Follow the steps to complete the Medical Certification Form online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering the name of the applicant in the designated field to identify the individual being examined.
3. Document the date of the examination in the field provided. This information is essential to validate the medical assessment.
4. Select the appropriate medical fitness determination by checking the applicable box: 'is medically fit to safely operate a TLC licensed vehicle' or 'is not medically fit to safely operate a TLC licensed vehicle'.
5. If the applicant is not medically fit, specify the disqualifying reasons in the space provided to offer clarity on the decision.
6. Fill in the physician’s last name and first name in the specified fields to authenticate the evaluation.
7. The physician must then sign the form to validate the medical examination.
8. Provide the mailing address, including number, street, city, state, and zip code where the physician can be contacted.
9. Enter the physician’s license number as a requirement for verification purposes.
10. Include the physician's phone number for any follow-up necessary.
11. Ensure that the official stamp from the physician is placed on the form as it is a mandatory element for validation.
12. After all fields are completed, review the information for accuracy. Save changes, download, print, or share the form as needed.

Complete your Medical Certification Form online today to ensure a smooth application process.