The SAAQ sends form 28, Rapport sur l'état de santé – Permis de conduire (in English, Report on a Person's State of Health), when it needs to assess a driver's fitness, for example at age 80 and every two years after. A health professional, usually the treating physician, reports on vision, hearing, neurological, seizure, heart, respiratory, diabetes, psychiatric, substance use, functional and medication issues. The SAAQ then decides whether to maintain, condition or suspend the licence.
A health professional completes numbered sections 1 to 13 and the professional information block; the SAAQ usually designates the person's regular treating physician but may name a specific specialty. The person examined signs the page 1 authorization letting the SAAQ discuss their medical information with the signing professional.
Page 1 shows the driver's licence number, name, date of birth, address and telephone numbers. The SAAQ prints the person's name, licence classes and any licence conditions on the forms it sends; if you find a driving-relevant impairment with no matching condition, the SAAQ has not been told about it. The person signs an authorization letting the SAAQ discuss their medical information with you.
The exam must cover past and current conditions that may affect driving; tick every applicable box, or NO when there is nothing to report. Section 1 takes Snellen acuity for both eyes with and without correction and flags AMD, bilateral cataracts, glaucoma, pseudophakia, retinopathy, confrontation field defects and diplopia; you can note here that a fuller eye exam is indicated. Section 2 records the forced-whisper test at 1.5 metres and whether a hearing aid was needed.
Section 3 lists CVA, Parkinson's, MS, brain tumour, head trauma or other, with diagnosis date and current symptoms; if the diagnosis brings functional limitations, complete section 10 too. The SAAQ's guide asks physicians to state what the person can no longer do, not just the diagnosis. Section 4 records seizure type, first and last seizure dates, nocturnal seizures, the cause of any non-epileptic seizure and how seizures manifest.
Section 5 covers functional class III or IV heart disease, arrhythmia, defibrillator implant and last shock dates, an aortic aneurysm requiring surgery with its diameter, and syncope in the last 12 months with cause and treatment. For professional classes 1, 2, 3, 4A and 4B, give the ejection fraction in heart failure. Section 6 records respiratory functional category, oxygen therapy, and sleep apnea treatment effectiveness, hours of use, daytime sleepiness and apnea-hypopnea index.
Section 7 asks whether the person understands and controls their diabetes, the treatment (insulin or a hypoglycemic agent), and any waking hypoglycemia in the last six months that altered consciousness and needed a third party's help; professional drivers need an HbA1c. Section 8 covers uncontrolled psychiatric disorders: a DSM-5 diagnosis, judgment and self-criticism for driving, symptoms, psychotic or manic episodes in 12 months, and unfitness for professional classes.
Section 9 follows DSM-5: substance type, severity by number of criteria, remission start date and consumption before and after remission; the SAAQ's guide says daily prescribed cannabis can be noted here like any medication. Section 10 covers physical and cognitive limitations, limits on daily activities, dementia with cause and severity, and changes in physical or cognitive function over 12 months. The SAAQ notes that functional limitations often weigh more in its decisions than the diagnosis itself.
List medication in the named classes (anticonvulsants, antidepressants, antipsychotics, anxiolytics or sleep aids, opioids or narcotics) with name, dose and frequency, and enclose a list for other classes. Then say whether the person has side effects that affect safe driving, such as reduced alertness, psychomotor slowing, drug interactions or polypharmacy, and describe them and their severity.
Indicate whether the SAAQ should require further assessment: a road test by an SAAQ examiner, a functional driving assessment by an occupational therapist, or specialized consultations, naming the specialties. Then say whether the person should stop driving while awaiting those assessments. The SAAQ makes the licence decision, and its FAQ lists a physician's recommendation to stop driving pending assessment among the reasons it orders an urgent on-road reassessment.
Use section 13 for anything not captured elsewhere that may pose a risk when driving; the SAAQ's FAQ says diagnoses missing from the checklists can be written here. Then give how long the person has been under your care and visits per year, or who provides their care, followed by your name, profession, licence number, contact details, signature and report date. Attach any documents you consider relevant.
Download the current version from the source each time; forms change without notice.
Report on a Person's State of Health (28)
Rapport sur l'état de santé – Permis de conduire
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The person being examined. Page 1 of form 28 states that all fees for completing it must be paid by the person undergoing the examination and are not reimbursable by the SAAQ. This differs from the SAAQ's road-accident compensation reports, such as the initial report, which the SAAQ pays for.
The SAAQ sets the deadline in the letter that comes with the form, along with the reason for the request and the consequences of missing it. Its guide says the period is usually 90 days and can be shorter. The licence is suspended administratively if the deadline passes, but the driver can ask for an extension with a valid reason, such as no timely appointment.
Yes. The SAAQ's guide and FAQ call the medical examination report form M-28 (Rapport d'examen médical). The current version, 6228 30, is titled Rapport sur l'état de santé – Permis de conduire, with an English version numbered 6228A-30. The SAAQ describes its revisions as minor, letting some sections capture more diagnoses and directing other diagnoses to section 13.
If the SAAQ requests the report during a periodic or statutory review while the person has a temporary incapacity, its guide says the incapacity should appear on the report with the expected date of return to safe driving. The driver may instead ask the SAAQ to postpone the deadline for returning the completed form.