Alabama's Department of Revenue issues disability access placards and license plate decals on this one-page form. The bottom section is a medical certification that the applicant's ability to walk is limited or impaired, either permanently or temporarily for up to six months. Certification is needed before the first issuance; people with permanent disabilities can self-certify at renewal.
The applicant, a parent, stepparent or legal guardian, or a transporting organization completes the applicant information and signs under penalty of perjury. A licensed physician, certified registered nurse practitioner or certified nurse midwife completes the Requirements and Certification section, checking each qualifying condition and the length of disability.
Download the current version from the source each time; forms change without notice.
Application for Disability Access Parking Credentials
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A licensed physician, certified registered nurse practitioner or certified nurse midwife. The certifier checks each qualifying walking condition, marks permanent or temporary with dates, and affirms under penalty of perjury that the applicant has the disability, adding printed name, medical license number if applicable, phone and office address.
Not for permanent disabilities. The form says an individual with permanent disabilities may self-certify the qualifying disability when renewing, and replacement credentials need no separate certification. Certification from a physician, CRNP or certified nurse midwife is required before the initial issuance of any placard or decal.