Iowa residents use form 411055 to apply for a persons with disabilities removable windshield placard, sticker or plates. The form itself has no clinician section: the applicant attaches a signed medical statement on the practitioner's letterhead. A clinician meets this request when a patient's walking is limited enough to qualify and the Iowa DOT needs to know whether the disability is permanent or temporary.
The applicant completes and signs the application. A physician (including a podiatrist), chiropractor, physician assistant, nurse practitioner, occupational therapist or physical therapist licensed in any U.S. state writes and signs the separate statement.
Download the current version from the source each time; forms change without notice.
Application for Persons with Disabilities Parking Permit for Iowa Residents (with practitioner medical statement)
This form is completed online with Iowa Department of Transportation, Motor Vehicle Division, so there is no PDF to fill. Vero Scribe writes the visit note it draws on, so the details are ready when you complete it.
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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Iowa DOT asks for a statement on the practitioner's letterhead, signed by the practitioner, that includes a determination of whether the disability is permanent or temporary. For a temporary condition, the practitioner may set an expiration date earlier than the default six months.
Yes. Iowa accepts statements from physicians (including podiatrists), chiropractors, physician assistants, nurse practitioners, occupational therapists and physical therapists licensed in any U.S. state, which helps residents treated across state lines. The applicant must still be an Iowa resident.
A temporary placard expires six months from issue, or earlier if the medical professional indicates a shorter period. A permanent placard expires five years from issue. Stickers last as long as the vehicle registration is current.