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MED 2 (07/01/2020)CUSTOMER MEDICAL REPORT Purpose:Use this form to request medical information from your physician, physician assistant or nurse practitioner.Instructions: Follow the detailed INSTRUCTIONS.

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How to fill out the VA DMV MED 2 online

Completing the VA DMV MED 2 form is essential for providing medical information regarding your ability to operate a motor vehicle safely. This guide will walk you through each step to ensure you fill out the form accurately and efficiently.

Follow the steps to successfully complete your VA DMV MED 2 form.

  1. Click ‘Get Form’ button to obtain the document and open it in the online editor.
  2. Begin by filling out the Customer Information section. Provide your last name, first name, middle initial, and suffix, along with your customer number or social security number. Fill in your residence address, birth date, and daytime telephone number.
  3. In the section regarding your medical condition, provide detailed information describing your current health issues. Indicate whether you take any prescription or non-prescription medications, including dosages and times taken.
  4. If applicable, answer questions about whether you have experienced blackouts, seizures, or loss of consciousness. Provide the dates and experiences related to these incidents.
  5. Complete the Information Release Approval section by authorizing your medical provider to submit the Customer Medical Report to the DMV. Ensure that your signature and date are included.
  6. After completing the Customer Information and Information Release Approval sections, take the entire MED 2 form along with your DMV letter to your medical provider for them to fill out the relevant sections regarding your health.
  7. Once your medical provider completes their part of the form, ensure that they return it to the DMV as per the provided fax numbers.
  8. Finally, keep a copy of the filled form for your records. You can save changes, download, or print the form as needed.

Complete your VA DMV MED 2 form online today to ensure your medical information is submitted accurately.

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