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NL MRD Update Cognitive Function Form (MoCA)

Newfoundland and Labrador's Motor Registration Division sends this letter-form after it receives information that a driver may have memory problems. Citing chapter 6 of the CCMTA medical standards, it asks the driver's health care provider to place the driver in one of four columns, from mild cognitive impairment to severe dementia, and to give a MoCA score and date. MRD needs the update to determine fitness to drive.

Who completes it

The driver's health care provider, a physician or nurse practitioner, picks the column, records the MoCA and any comments and signs; the driver signs the form as well.

Submitting and payment

How to submit it
Return it to MRD's Medical Section by mail or fax, using the contact details printed at the bottom of the form.
Who pays
The form states that the driver is responsible for any costs.

Good to know

  • The four columns are A (mild cognitive impairment), B (mild dementia), C (moderate dementia) and D (severe dementia), each with functional descriptors such as managing finances, dressing or toileting.
  • Only a MoCA score and its date are requested as test results; other findings go in the comments box.
  • The form quotes the CCMTA description of mild cognitive impairment under DSM-5: cognitive decline without significant functional impairment, between normal aging and dementia.
  • It cites Highway Traffic Act sections 171, 174.1, 174.2, 195(3), 63(1), 45(6)(b) and 84.1, with the CCMTA Medical Standards for Drivers, as its authority.

Get the official form

Download the current version from the source each time; forms change without notice.

Update Cognitive Function

Official pagePDF

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How this list is checked

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.

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Frequently asked questions

Why does Motor Registration send an Update Cognitive Function letter?

MRD sends it when it has received information that the driver may have memory problems. The letter explains that chapter 6 of its medical standards requires a medical assessment to determine fitness to drive once memory problems are identified, so the driver's health care provider is asked to complete the form.

What cognitive test does the NL Update Cognitive Function form ask for?

It asks for the driver's MoCA score and the date the MoCA was done. The provider also chooses the column, A to D, that best describes the driver's status, from mild cognitive impairment through mild, moderate and severe dementia, and can add comments before signing.

Who pays for the Update Cognitive Function form?

The driver does. The letter tells the driver they are responsible for any costs of having their health care provider complete it, and that they can call MRD's Medical Section toll-free if they cannot get the form done or have questions.