The medical certification on state placard and plate applications, plus transit agencies' paratransit and reduced-fare forms, grouped by state.
State motor vehicle agencies ask a clinician to certify the disability behind a parking placard or plate, usually in a section of the application itself: California's REG 195, Texas's VTR-214, New York's MV-664.1, Pennsylvania's MV-145A and Arkansas's 10-336. Transit agencies run a second set of forms for ADA paratransit and reduced fares, such as the MBTA's TAP CharlieCard certification and the Puget Sound Regional Reduced Fare Permit. The list also has the physician statement for the federal Access Pass and an airline's portable oxygen concentrator authorization.
Who may certify varies by state, from physicians only to PAs, NPs, chiropractors and podiatrists, with optometrists for vision. Signature rules vary too. Texas requires a notarized signature for placards unless an original prescription comes with the form. Delaware's MV474 and Connecticut's B-225P must be originals, with no faxes or photocopies. California and Massachusetts want a written diagnosis, not just an ICD code or symptoms. Spanish versions exist for 14 forms. Vero Documents fills these PDFs from the visit note and the chart.
Licensed physician attests that the applicant has a permanent physical, mental or sensory impairment that substantially limits one or more major life activities, qualifying them for the free lifetime federal recreation Access Pass.
Physician's statement that a passenger can see, hear and respond to POC alarms, whether oxygen is needed for all phases of flight, and the flow setting at 8,000 ft cabin altitude, required before using a portable oxygen concentrator on Frontier.
Applies for disability access placards or license plate decals, with medical certification that the applicant's walking is limited or impaired (permanent or temporary up to six months).
Applies for a permanent, temporary or visitor disability parking permit or plates with parking privileges, with a licensed Alaskan professional's certification of the qualifying condition.
Certifies that a patient is permanently or temporarily disabled (conditions A-L) for a disability license plate or parking certificate (placard).
Applies for a permanent, temporary or travel disabled person (DP) parking placard or DP license plates, with the medical provider's certification of the qualifying disability.
Clarifying information from the applicant's treating professional that the Access evaluator may request to decide ADA paratransit eligibility after the in-person evaluation.
Certifies a disability category (1-19) that limits use of fixed-route transit so the applicant gets the Clipper Access discount card for Bay Area transit.
Professional's list of diagnoses and explanation of why the applicant cannot independently use SacRT bus or light rail, required for SacRT GO ADA paratransit eligibility.
Licensed provider's description of the applicant's functional abilities and limits on MTS bus and trolley, used with the in-person assessment to decide MTS Access ADA paratransit eligibility.
Physician statement of a qualifying medical disability so an applicant without Medicare/SSI/DMV placard/VA documentation can get a disabled reduced-fare PRONTO photo ID.
Applies for disability license plates or a permanent or short-term (temporary) placard, with written verification of the qualifying disability by a medical professional.
Applies for a renewable (permanent) disability parking placard with medical certification of blindness or a qualifying disability.
Applies for a temporary disability parking placard with medical certification of the temporary disability.
MV474Applies for a long-term disability license plate/parking placard or a temporary (180-day) placard, with physician certification under 21 Del. C. 2134/2135.
Applies for ADA complementary paratransit (MetroAccess) eligibility in DC, suburban Maryland and Northern Virginia; the provider certification feeds the in-person functional assessment.
DMV-MF-DPLP-01Solicitud para Carteles y Etiquetas de Estacionamiento para Discapacitados
Applies for or renews disability parking tags (plates) and/or a temporary or long-term placard, with a medical practitioner's answers on mobility impairment.
Certifies a qualifying disability so a person under 65 can get the Reduced Fare (half-fare) Disability SmarTrip photo ID for Metrobus and Metrorail.
Applies for ADA paratransit (Special Transportation Service) eligibility in Miami-Dade County; the physician's medical verification documents why the applicant cannot use Metrobus/Metrorail/Metromover.
Medical certification of a disability for Florida Transportation Disadvantaged (state-funded) door-to-door service in Orange, Osceola and Seminole counties when the applicant qualifies on disability rather than income/no-bus grounds.
Florida-certified physician or medical professional's certification of a disability for a HART discount disabled permit on local bus routes.
Applies for a temporary, permanent or special permanent disability parking placard or disabled person's license plate, with a notarized health care provider certification.
Certifies a mental or physical disability so the applicant can get a reduced-fare Breeze Card.
Professional certification of the applicant's ability or inability to use MARTA bus and rail, used to decide ADA paratransit (MARTA Mobility) eligibility categories 1-3.
Applies for a temporary (red), long-term (blue) or Disability Paid Parking Exemption (green) placard or special license plates, with a medical certification of the qualifying impairment.
Applies for disability license plates or a temporary (1-6 months) or permanent special parking placard, with medical certification that the patient meets Idaho Code 49-117.
Professional verification of a disability so a person under 65 gets the Reduced Fare Permit for CTA, Metra and Pace in northeastern Illinois.
Medical certification for a temporary, permanent or meter-exempt disability parking placard (and renewal for disability plate holders).
State Form 42070Applies for a disability license plate or a permanent or temporary disability parking placard, with a health care provider's certification of the disability.
Applies for a removable windshield placard, sticker or standard plates; must be accompanied by a medical statement certifying a permanent or temporary disability.
Applies for a disabled identification placard, disabled license plate or decal, with a healing arts licensed professional's certification under K.S.A. 8-1,124 (temporary or permanent).
Applies for a disabled license plate or a permanent or temporary disabled parking placard, with certification of the disability.
Certifies a permanent or temporary mobility impairment for a mobility impaired (handicap) hang tag or license plate (R.S. 47:463.4).
Applies for a permanent or temporary (max 6 months) disability placard or disability plates, with the medical provider's statement of the qualifying condition (including recovery from childbirth).
Certifies a disability expected to last 90+ days that prevents effective use of mass transit, for a Reduced Fare Photo ID on MDOT MTA services.
Healthcare/disability professional certification of the applicant's condition and functional limits for MobilityLink ADA paratransit eligibility in the Baltimore region.
Certifies a disability category so the applicant can receive a Transportation Access Pass (TAP) reduced-fare CharlieCard.
Applies for a temporary or permanent disability placard, disability plate or disabled veteran plate, with the healthcare provider's clinical diagnosis and certification of severe mobility restriction.
Additional information from the applicant's health care provider that the MBTA Mobility Center may request when deciding ADA paratransit (The RIDE) eligibility.
Applies for or renews a permanent or temporary disability parking placard, with certification by a licensed medical professional.
Licensed professional's documentation of the applicant's disability and functional limits, required with the SMART ADA Application for ADA paratransit certification in suburban Detroit.
Applies for a temporary, short-term, long-term or permanent disability parking certificate (hangtag), with a health professional's certification under Minn. Stat. 169.345 and whether the patient is medically qualified to drive.
Professional verification of the applicant's condition and functional limits, submitted with the Certification Questionnaire to decide ADA paratransit (Metro Mobility) eligibility in the Twin Cities.
Applies for a permanent or temporary (up to 6 months) disabled parking placard or disabled license tag, with certification of a qualifying walking/lung/cardiac condition (Miss. Code 27-19-56).
Certifies a physical disability under RSMo 301.142.1 for new disabled person license plates or placards (permanent or temporary) and every eighth year at renewal.
Written professional verification of disability required (new and recertifying applicants) for Metro Call-A-Ride ADA paratransit eligibility in St. Louis.
Applies for a permanent (5-year) or temporary (up to 2-year) disability parking placard, with a medical provider's certification.
Applies for physical disability license plates (permanent disabilities, MCA 49-4-301) with a medical provider's certification.
Certifies a mobility, visual, respiratory or cardiac impairment so the applicant can get a permanent or temporary handicapped parking permit.
Certifies a qualifying disability so the DMV can approve handicapped license plates (and optionally a permanent permit).
Certifies a qualifying mobility disability for a veteran on the Nebraska Veterans Registry applying for military handicapped plates.
Certifies a temporary (up to 6 months), moderate (up to 2 years) or permanent disability for disabled plates, placards or motorcycle/moped stickers.
Medical provider certifies a temporary (up to 6 months) or permanent walking disability (RSA 259:124, 261:88) for walking disability placards or plates.
Medical practitioner certifies a qualifying permanent disability (limb loss, inability to walk unaided, lung disease, AHA class III/IV cardiac, etc.) for initial, recertification or replacement wheelchair-symbol plates or placard.
Medical practitioner certifies a temporary loss of limb use or mobility so the local police department can issue a temporary disability placard (up to 6 months, one recertification).
Physician or NP certification of a disability so the applicant (and a personal assistant, if needed) gets an NJ TRANSIT Reduced Fare ID.
Physician certifies a significant mobility limitation (Section 66-3-16 NMSA) and whether it is permanent or temporary (up to 12 months) for a parking placard.
Certifies a qualifying disability (hearing, vision, ambulatory, cognitive, other physical, or serious mental illness with SSI) so the applicant gets a Reduced-Fare MetroCard/OMNY benefit on MTA subway, bus and commuter rail.
Medical professional certifies a temporary or permanent severe disability (VTL 404-a) for a local parking permit or DMV license plates with the International Symbol of Access.
Medical professional certifies a permanent severe disability that also limits hand control, reach or meter access, for a metered parking waiver.
Licensed medical provider certifies a mobility impairment (G.S. 20-37.5) for a temporary (1-6 months), regular or total-and-permanent disability parking placard.
Health care provider's verification of the applicant's disability and how it affects use of fixed-route buses, for CATS STS ADA paratransit eligibility.
Medical provider certifies a qualifying mobility impairment so the applicant can register a vehicle with disability license plates.
Renews a disability placard; a medical provider recertifies the impairment when recertification is required.
MedVer2023Licensed provider's diagnosis and functional answers (walking 200 feet, wayfinding, need for PCA, mobility devices) supporting an ADA paratransit (Access) eligibility application in Cincinnati.
Solicitud de Mainstream
Licensed professional's detailed account of the functional limitations that prevent use of COTA fixed-route buses, for Mainstream ADA paratransit eligibility in Franklin County.
Physician certifies a qualifying mobility, respiratory, cardiac or vision condition for a temporary (up to 6 months) or 5-year disability parking placard.
Healthcare provider certifies the applicant is a 'person with a disability' (ORS 801.387) for a temporary, non-temporary or wheelchair-user parking placard or decal.
Licensed provider's certification of a permanent or temporary disability (and need for an attendant) so the applicant gets a TriMet Honored Citizen reduced-fare photo Hop card.
Healthcare provider certifies disability for a person (often a child or someone unable to visit DMV) who needs a parking ID card plus a renewable, temporary or wheelchair-user placard.
Physician certifies eligibility of disabled family members for a family disabled person parking permit (ORS 811.609).
Health care provider certifies a qualifying disability for a permanent or temporary person-with-disability parking placard (also severely disabled veteran, renewal, replacement).
Professional's report of the applicant's functional skills for using regular SEPTA buses and light rail, required with the ADA paratransit application before the functional assessment.
Physician certification of a qualifying disability (FTA criteria) for a PRT reduced-fare transit ID card for riders under 65 without Medicare.
Health care provider certifies a qualifying disability or hearing impairment for person-with-disability or hearing-impaired registration plates.
Eye doctor's report of corrected acuity, fields and functional effect of a vision disability for SEPTA Access ADA paratransit eligibility.
DTOP-DIS-010Application for Removable Placard Parking Permit for Persons with Physical Disabilities
Specialist physician certifies one of the qualifying conditions listed in Ley 22-2000 (paralysis, amputation, severe cardiac/respiratory disease, morbid obesity, MS, severe Down syndrome, etc.) for a permanent or temporary removable placard (rótulo removible).
Physician's statement certifies a permanent (4-year placard, plates) or temporary (4 months to 1 year) disability, including the autistic/neurodivergent plate option.
Physician certifies a walking-limiting physical disability (200-foot rule, assistive device, oxygen, lung/heart condition, arthritic/neurological/orthopedic limitation) for a permanent or temporary (up to 12 months) portable parking permit or disabled person plates.
Licensed professional's certification of a severe disability (diagnosis, onset, prognosis) supporting WeGo Access ADA paratransit eligibility in Nashville.
Licensed medical professional certifies a permanent or temporary disability (Transportation Code 681.001: mobility or vision) for a disability placard and/or license plates.
Treating provider's verification of diagnoses, visual acuity, mobility devices and hypertension clearance for MetroAccess ADA paratransit eligibility in Austin.
Clinician verification of diagnoses, onset dates and mobility aids that prevent the applicant from using DART bus and rail, required with the ADA paratransit certification form.
Aplicación de Servicio de VIAtrans
Medical professional's description of the disability and functional limits for VIAtrans ADA paratransit eligibility in San Antonio/Bexar County.
METRO 0447-20Doctor's or health professional's description of what prevents the applicant from using METRO bus and rail, required for METROLift ADA paratransit eligibility.
Physician's answers on seizure/epilepsy diagnosis, last seizure, type and frequency to decide DART ADA paratransit eligibility for applicants with seizure disorders.
Eye doctor's verification that the applicant is legally blind in both eyes (fields/acuity, prognosis) for DART ADA paratransit eligibility.
Medical professional certification of a qualifying disability (per FTA reduced-fare criteria) for a VIA Reduced Fare ID.
Verification by a local intellectual/developmental disability authority or clinician/therapist of a behavioral health or intellectual disability diagnosis for DART ADA paratransit eligibility.
Clinician certifies a temporary (up to 6 months, not renewable) or permanent disability for Utah disability parking placards or plates.
Licensed healthcare professional's verification of an ADA disability so the applicant qualifies for a UTA Reduced Fare FAREPAY card when no other proof (e.g. Medicare) is available.
Clinician certifies a temporary ambulatory handicap and recommends a placard expiry (6 months maximum, not renewable).
Clinician certifies a temporary or permanent walking limitation or safety condition for a disabled parking placard or disabled parking license plates.
Certifies a disability against the RRFP Medical Eligibility Criteria so the applicant gets a reduced-fare ORCA card valid on regional transit (King County Metro, Sound Transit, Community Transit, Pierce Transit, Kitsap Transit, Everett Transit, WSF).
Healthcare provider certifies a qualifying condition and whether disabled parking should be permanent (5 years) or temporary (up to 12 months) for placards, plates or tabs.
Healthcare professional's co-signature and approval of an ADA paratransit (Access) eligibility application in King County, WA; the application is incomplete without it.
Licensed physician certifies a permanent or temporary (up to 6 months) mobility impairment for a WV mobility impaired placard and/or plate.
Licensed physician certifies a permanent or temporary mobility impairment for a disabled veteran's mobility impaired plate (after WV Department of Veterans Assistance certification).
Permiso de Estacionamiento para Personas con Discapacidad Permanente Información y Solicitud
Health care specialist certifies a permanent disability for a Wisconsin disabled parking identification (DIS ID) permit.
Permiso de Estacionamiento para Personas con Discapacidad Temporal Información y Solicitud
Health care specialist certifies a temporary disability for a temporary Wisconsin DIS ID parking permit.
Licensed healthcare professional's verification supporting a Transit Plus ADA paratransit application in Milwaukee County.
Placas de Estacionamiento para Personas con Discapacidad Información y Solicitud
Health care specialist certifies a permanent disability for disabled parking license plates (s. 341.14(1a)); optionally adds a DIS ID permit.
Treating provider certification that a rider's permanent or temporary impairment meets MCTS reduced-fare disability criteria, for a Reduced Fare ID card.
Licensed medical professional certifies the person is an 'eligible person' (W.S. 31-2-213) for a temporary (up to 6 months) or permanent placard; plates then come from the County Treasurer.
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 and their requirements change without notice, so check the official page for the current version before you complete one.
Vero is not affiliated with, or endorsed by, the agencies and insurers listed here. Read our editorial policy.
It depends on the state. California's REG 195 accepts a physician, surgeon, PA, NP or certified nurse-midwife, with chiropractors limited to items 6 to 8, podiatrists to foot and ankle conditions and eye doctors to vision. Texas's VTR-214 accepts a physician, podiatrist, optometrist or qualifying PA or advanced practice nurse licensed in Texas, Arkansas, Louisiana, New Mexico or Oklahoma. Pennsylvania's MV-145A accepts providers licensed in Pennsylvania or a contiguous state.
For a placard, yes, unless you submit an original prescription stating whether the disability is permanent or temporary. The licensed medical professional completes the Disability Statement on page 2 and certifies a mobility or vision disability under Transportation Code 681.001. The applicant files the form with the county tax assessor-collector in the county where they live or receive treatment.
A legible description of the condition. California's DMV doesn't accept just an ICD code or a list of symptoms. You certify Sections 5, 6 and 6A on page 3 under penalty of perjury and must keep records that support the certification. The same form covers temporary placards for up to 180 days, permanent placards and disabled person plates.
Most have a professional verification section. The Puget Sound Regional Reduced Fare Permit takes a Washington-licensed physician, psychiatrist, psychologist, PA, ARNP or audiologist, and accepts original signatures only, with no photocopies or faxes. The MBTA's TAP form must arrive within 60 days of your signature. Some agencies accept other proof instead, such as a Medicare card, so the patient may not need the form at all.