Montana's Motor Vehicle Division sends this four-page evaluation when its records show a driver may have a condition that could affect safe driving. The physician or provider reports history, medications, any lapse of consciousness, impairments and diagnosis, and recommends adaptive equipment, restrictions and periodic testing; MVD makes the licensing decision and also weighs non-medical factors.
The patient signs the release in Section 1a in the provider's presence and marks whether the credential is a Class D license or a CDL; the physician or treating provider completes Sections 2 through 10.
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Driver Medical Evaluation
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The patient's release on the form states that any expense involved is to be charged to the patient and not the State of Montana. The patient signs that release in the physician's or provider's presence before the evaluation sections are completed.
The form's introduction states that a physician reporting in good faith is immune from liability, civil or criminal penalties under 37-2-311 and 37-2-312, MCA. MVD has sole responsibility for the licensing decision and also considers non-medical factors.
Yes. Section 7 lists a steering knob, mechanical turn indicator, pedal extension, hand controls, manual brake, automatic transmission and other equipment. The form notes that MVD may not be able to add recommended restrictions in certain situations.