RoadSafetyBC sends this report to drivers it needs medical information about: drivers at age 80 and periodically after, commercial drivers on a set schedule, and drivers with known or suspected medical conditions. The driver brings it to a physician or nurse practitioner, who examines them and returns it to RoadSafetyBC, which decides whether the person is medically fit to drive. The exam does not include a road test.
A physician or nurse practitioner completes Sections A to E and G (history, vision screening and physical findings, opinion, details, recommendations and relationship with patient) and signs. The driver completes and signs Section F, the certification and consent to release information.
Before you start, read the pre-printed reason for examination and licence class; the instructions call this essential, and the form says the report must focus on the BC Guide conditions noted there. Confirm the driver's Personal Health Number in the boxes at the top. MSP fee code 96220 is printed here for Teleplan billing, and the instructions ask you to make sure the 7-digit driver's licence number is entered.
Tick and date the conditions present in each body-system box. Each box is keyed to a section of the CCMTA Medical Standards with BC Specific Guidelines, for example vision (2), cardiovascular (4), CNS, cognition and seizures (7), psychiatric (12), drugs and alcohol (13 and 14), endocrine (9) and general debility or frailty (17). Fields capture specifics such as MoCA and Trails B scores, date of last seizure, LVEF and NYHA class, AHI, Epworth score and CPAP compliance, HbA1c and severe hypoglycemia dates. Give full information on any condition that, in your opinion, may affect driving.
Record uncorrected and corrected visual acuity for the right eye, left eye and both eyes, and whether the visual field is normal or abnormal. An EVF or visual field test done within the past year may be included if available. Then tick whether both acuity and field meet the guide's criteria for the licence class on the form, and give full information on any physical finding that may affect driving, continuing in Section D if needed.
This section must be completed. Having completed A and B, give your opinion on whether the patient has a condition that may affect driving: No, Yes, or May in future, with a recommended follow-up interval in years. RoadSafetyBC makes the licensing decision, guided by the CCMTA Medical Standards with BC Specific Guidelines, and relies on your opinion and the detail behind it.
Give complete, thorough details of each noted condition and of any medications that may affect driving, and attach relevant specialists' reports or lab results. RoadSafetyBC says incomplete information may lead it to ask the driver to return to their physician for more. Use this space to expand on anything ticked in Sections A and B.
Recommend a specialist consultation (state the type, whether a report is enclosed and whether you will arrange it), a road test with your rationale, or restrictions with the reason and type. The back of the form lists BC licence classes and restriction codes, such as corrective lenses required, daylight hours only, automatic transmission only or specified vehicle modifications. RoadSafetyBC may also require further assessments, such as an Enhanced Road Assessment, an occupational therapist assessment or an ICBC road test re-examination.
The driver signs and dates this section, certifying that what they told you is true and complete, acknowledging that inaccurate, missing or false information may lead to denial or cancellation of their licence, and authorizing release of this and past or future reports on conditions that may affect driving to the Superintendent of Motor Vehicles.
Indicate whether you are the family physician or nurse practitioner and for how many years, or a locum, walk-in, first-visit, NP or specialist examiner. Print or stamp your name and address, add your telephone number and the examination date, and sign. Then fax or mail the report as printed on the front, keeping a copy for your records if you mail it.
Download the current version from the source each time; forms change without notice.
Driver's Medical Examination Report (DMER)
If your copy of the form is a fillable PDF, upload it once and Vero Documents fills it from the visit note and the chart, ready for you to review and sign. Download, print, or email the finished form, with the patient’s consent.
A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms change without notice, so download the current version from the official page before you fill it in.
Sources for this guide
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Blue DMERs go to drivers with known or suspected medical conditions, for example after reliable information from police, family, a medical professional or ICBC. Yellow DMERs are routine: they go to drivers at age 80 and periodically after, and to commercial drivers at set intervals. RoadSafetyBC reimburses physicians for blue reports, but not for yellow ones.
The form gives 45 days for the physician or nurse practitioner to complete and return it. If the exam is for a licence class the driver already holds, the licence may be cancelled when the deadline passes. Drivers who cannot meet it should contact RoadSafetyBC or ICBC as soon as possible to ask for an extension.
Yes. The form is addressed to the physician or nurse practitioner, and RoadSafetyBC's page for medical professionals says it accepts reports completed by nurse practitioners licensed to practise in Canada or the United States. The Teleplan billing arrangement printed on the form is described for physicians.
It depends on the type. For a blue DMER requested because of a medical condition, MSP covers a set amount billed under fee code 96220, and the driver pays anything above it. Age-based and commercial yellow DMERs are not covered by MSP; practices set the fee, and Doctors of BC recommends reducing or waiving it for patients facing economic hardship.