SAAQ Functional Driving Assessment Report (Form 57)

When the SAAQ requires a functional assessment of a driver's physical and mental fitness, an occupational therapist documents it on this six-page report. It covers medical history, vision, limbs and spine, perceptual and cognitive functions, communication and behaviour, then a road test. The SAAQ's FAQ explains that the assessment links office findings to on-road performance, showing whether driving is unsafe and why.

Who completes it

A member of the Ordre des ergothérapeutes du Québec completes all nine sections and signs; the person being examined signs an authorization for the SAAQ to discuss their medical information with the therapist.

Submitting and payment

How to submit it
Return the form by mail to the SAAQ's Service de l'évaluation médicale et du suivi du comportement; relevant documents may be enclosed.
Who pays
Any fee for completing the form is paid by the person undergoing the examination and is not reimbursed by the SAAQ.

Good to know

  • The SAAQ requires the road test to include situations of increasing complexity, at least various speed limits, familiar and unfamiliar routes, unprotected left turns, and rural and urban roads.
  • If the road test is not appropriate, the therapist must say why; if it is, the route and how the test was carried out must be described.
  • Results include pass or fail, rehabilitation potential, accompanied driving with a driving school monitor or OT, and licence conditions such as hand-operated controls or an accelerator on the left.
  • The SAAQ's occupational therapist page warns that an incomplete assessment will not allow the SAAQ to rule, so any manoeuvre not assessed needs a valid reason.

Get the official form

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

Functional Assessment Report on Physical and Mental Fitness to Drive (57)

Rapport d'évaluation fonctionnelle sur l'aptitude physique et mentale à conduire un véhicule routier

Fill it with Vero

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.

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

Who can complete SAAQ form 57?

The form states it is to be completed by a member of the Ordre des ergothérapeutes du Québec. The Order's website lets the public find occupational therapists in their region who perform functional driving assessments, and the SAAQ offers a bursary and mentorship program for therapists entering the field.

How is an OT functional assessment different from an SAAQ road re-assessment?

Both include a road test, but an SAAQ evaluator only observes whether driving meets traffic rules and safety standards. The occupational therapist first runs an in-office battery of physical and neurocognitive tests, then the road test, so the report can explain why driving is unsafe, not just whether it is.

When does the SAAQ send someone for a functional driving assessment?

According to the SAAQ's FAQ, a person who needs vehicle modifications because of a physical disability is referred to occupational therapy. After a failed re-assessment at a service centre with no retake available, an occupational therapy evaluation is the only remaining option, and the person may submit this report.