Arkansas issues special license plates and parking certificates (placards) to people with disabilities after a licensed provider certifies the condition on form 10-336. In Part 1 the provider marks the disability as permanent or temporary and checks one or more conditions from A through L. Page 2 explains the parking rules, penalties and expiration periods that apply to the holder.
A licensed physician, physician assistant, physical therapist or advanced practice registered nurse completes Part 1, including their license number, the patient's details and the qualifying conditions, and signs. Part 2 is only for organizations that transport people with disabilities.
Download the current version from the source each time; forms change without notice.
Licensed Provider or Organization's Certification for Issuance of a Special License Plate or Certificate for a Person with a Disability
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.
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.
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A licensed physician, physician assistant, physical therapist or advanced practice registered nurse completes Part 1. The provider enters their license number, certifies that the person is or has been a patient under their care, circles permanently or temporarily, checks the conditions that apply and signs.
A permanent special certificate expires four years from the last day of the month it was issued, and the holder does not need a new medical certification to renew. A temporary certificate expires three months from the last day of the month it was issued.