South Carolina drivers can have up to three medical conditions, plus a blood type, noted by a caduceus symbol on the back of a non-commercial beginner's permit, license or ID card. This form is how they disclose them, with a South Carolina-licensed physician certifying the conditions and a medical provider certifying the blood type. The process is voluntary and completed at an SCDMV branch.
The applicant completes Sections 2 and 3 and signs; an SC-licensed physician completes the Section 4 Physician's Statement by checking conditions from the list, and a medical provider certifies the blood type with license number.
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Voluntary Disclosure of a Medical Condition and/or Blood Type
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 physician licensed in South Carolina under Chapter 47, Title 40 completes Section 4. Signing means the applicant has the selected conditions, and SCDMV adds the caduceus once the physician signs. Blood type, by contrast, can be certified by a medical provider who lists their provider type and license number.
SCDMV states it will not use information on this form to start any review of fitness to drive. If a review happens because of other triggers, the disclosed information may be used as part of that review.
Up to three medical conditions, shown by a caduceus symbol on the back of a non-commercial beginner's permit, driver's license or ID card under SC Code 56-1-80. If all disclosed conditions are later removed, the caduceus is removed too.