The SAAQ sends this two-page report to a licence holder whose neurological health must be assessed for driving. The health care professional describes neurological disorders with cognitive, motor, sensory, balance or coordination effects, then epilepsy, single seizures or non-epileptic seizures, with dates, circumstances and treatment. The report ends with an opinion on whether the SAAQ should require further assessments.
The examinee signs the authorization at the top; the examining health care professional completes sections 1 to 5 and identifies their profession, licence number and how long the patient has been in their care.
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Medical Neurological Examination Report (14)
Rapport d'examen médical neurologique
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For a single seizure, section 3 asks for an EEG report connected with the seizure. For epilepsy, the form instead asks for seizure types, timing (asleep or awake), first and last seizure dates, symptoms, circumstances, medication and dosage, and whether the person adheres to treatment and reports seizures.
The SAAQ's FAQ says a person who has had a seizure may have their licence suspended immediately. In other situations the SAAQ must usually give 20 days' notice before a suspension takes effect, and it often asks for more information before deciding on a report.
The examinee. The form states that any fees for completing it are paid by the person examined and are not reimbursed by the SAAQ. The SAAQ sends the form to the licence holder, who has it completed by a health care professional and returned through SAAQclic or by mail.