Pennsylvania clinicians report a driver's loss of consciousness or awareness on this PennDOT form. PennDOT lists periodic episodes of loss of consciousness and/or awareness among its physical criteria, and the Bureau of Driver Licensing reviews the report against 67 Pa. Code Chapter 83 to decide whether the driver may keep driving, needs a restriction or exam, or faces recall.
The treating physician or other health care provider who evaluated the episodes completes the whole form.
Download the current version from the source each time; forms change without notice.
Loss of Consciousness
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PennDOT's criteria list periodic episodes of loss of consciousness and/or awareness. Providers must report, within 10 days, a patient diagnosed with a condition that could impair safe driving, unless the condition is expected to last less than 90 days. Seizures are reported on DL-121 instead.
DL-129SB, titled Loss of Attention, Awareness, or Consciousness of Unknown Etiology, is the Chapter 71 form for school bus drivers. DL-129 is used for drivers reviewed under Chapter 83, which covers drivers other than school bus drivers.
PennDOT may take no action, add a license restriction, request more medical information from the driver, who then has 45 days to comply, require a driver's exam, or recall the license until medical competency is demonstrated.