Insufficient information may result in no action. We are unable to divulge the outcome to you however we will provide this form to the driver or their attorney upon written request. Additional witnesses must complete separate forms. Return this form and any additional information or documents to Driver Records Department of Licensing PO Box 9030 Olympia WA 98507-9030 Based on my personal observation and knowledge I request the Department evaluate this driver s qualifications. Name of driver First Middle Last Date of birth Residence address City State ZIP code Driver license number Statement I am concerned that this driver has one or more of the following conditions that may affect their ability to safely drive Medical condition Vision condition Poor driving skills Details Knowledge of this driver is based on observation as a Law enforcement officer Agency Badge number here if there was a collision with a serious injury or fatality and the driver was at fault Check Medical professional ....
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How to fill out the WA DR-500-008 online
The WA DR-500-008 form is a crucial tool for assessing an individual's driving abilities based on specific medical or visual conditions. This guide provides a clear step-by-step approach to help users fill out the form accurately and efficiently online.
Follow the steps to complete the WA DR-500-008 form effectively.
- Click the ‘Get Form’ button to acquire the WA DR-500-008 form and open it in your online editor.
- Begin by filling in the driver's full name, including their first, middle, and last names.
- Enter the driver's date of birth in the designated field.
- Provide the driver's residence address, ensuring to include city, state, and ZIP code.
- Input the driver's license number accurately to facilitate tracking.
- Select the appropriate concerns regarding the driver's ability to drive safely by checking the relevant boxes for medical conditions, vision conditions, or poor driving skills.
- Provide details about your knowledge of the driver's capabilities, indicating whether you are a law enforcement officer or a medical professional, and include your agency name and badge or professional license number.
- If applicable, indicate whether there was a collision with serious injury or fatality and if the driver was at fault by checking the appropriate box.
- Input your name, mailing address, and contact telephone number in the fields provided.
- Review the certification statement and sign where indicated, affirming the truthfulness of the information provided under penalty of perjury.
- Once the form is completed, save your changes and print the document for signing and submission.
Complete your WA DR-500-008 form online today for a thorough driver evaluation.
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