Pennsylvania clinicians report neurological conditions that affect a driver's control of a vehicle on this PennDOT form. The Bureau of Driver Licensing weighs it against the Chapter 83 medical standards, and the result can range from no action to a license restriction, a driver's exam with vision, knowledge and skills testing, or recall until medical competency is shown.
The treating physician or other health care provider, often the clinician managing the neurological condition, completes the whole form.
Download the current version from the source each time; forms change without notice.
General Neurological Form
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Request health care personnel credentials from PennDOT's Medical Reporting Forms page; the PDF is protected and opens only with a medical reporting login. The form also has an online version that is completed and signed electronically, and finished paper forms can be mailed, faxed or emailed.
PennDOT's review process gives the driver 45 days to comply with a request for medical information. A driver who does not comply has the license suspended within 30 days for non-compliance.
Yes. Among PennDOT's possible actions is requiring a driver's examination, which includes a vision screening, a knowledge test and/or a skills test. PennDOT may also restrict the license, recall it until medical competency is demonstrated, or take no action.