Texas DPS DL-101 Communication Impediment Statement

Texas DPS can print 'Communication Impediment' or 'Deaf or Hard of Hearing' on a driver license or ID card when a licensed physician or psychiatrist signs this statement, under Transportation Code 521.142(h). The indicator tells peace officers the holder may need more time to respond or communicates differently. The clinician names the patient's medical condition and signs, and the applicant returns the form to DPS.

Who completes it

The patient completes the Patient Information block and signs; a licensed physician or licensed psychiatrist completes the Physician/Psychiatrist Information section, stating the medical condition with license number and state.

Submitting and payment

How to submit it
The applicant, not the clinician, returns the completed form to Texas DPS, presenting it at a driver license office with the DL or ID application; the indicator is added only after DPS has it.

Good to know

  • Examples DPS gives for the Communication Impediment indicator include autism and Asperger syndrome, Down syndrome, Parkinson's disease, aphasia, stuttering, PTSD, brain injury and cerebral palsy.
  • The Deaf or Hard of Hearing indicator is for people who communicate through methods such as ASL or assistive technology.
  • The completed statement is a confidential driver record under Chapter 730 of the Texas Transportation Code.
  • Other health conditions are not printed by DPS; the holder can mark the directive to physician on the back of the card and write the physician's phone number.

Get the official form

Download the current version from the source each time; forms change without notice.

Physician/Psychiatrist's Statement

How this list is checked

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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Frequently asked questions

Who can sign the Texas DL-101?

A licensed physician or a licensed psychiatrist. The statement asks for the clinician's name, office address and phone, medical license number and state, the patient's medical condition, signature and date. Transportation Code 521.142(h) requires the condition to be shown by this signed statement.

Which conditions qualify for a Communication Impediment indicator in Texas?

DPS describes this group as people who need more time to respond to a police officer, with examples including autism and Asperger syndrome, mild intellectual disability, Down syndrome, Parkinson's disease, speech and language disorders, PTSD, brain injury and cerebral palsy.

Is there a Texas form for a communication impediment on a vehicle registration?

Yes. DL-101 covers the driver license or ID card through DPS. For the vehicle record, the Texas Department of Motor Vehicles uses form VTR-216, Certification of a Communication Impediment, which is a separate filing.