Louisiana DPSMV 3005: Driver Behavior Report

This one-page report lets a health care provider, court, police agency, OMV employee or family member tell Louisiana's Office of Motor Vehicles about a driver who may not be able to drive safely. It goes to the OMV's Driver's License Suspension Unit, and the OMV may investigate and require medical statements or a special driving exam.

Who completes it

The reporter completes the whole form: the driver's identifying details, the reasons checked, a dated description of the incident or condition, other people familiar with the case, and a signature with title or relationship.

Submitting and payment

How to submit it
Send it to the OMV's Driver's License Suspension Unit at the address printed on the form. A report submitted by an OMV officer must be approved by a supervisor, and third-party reports are forwarded up the chain of command for review.

Good to know

  • The OMV accepts reports only when they contain firsthand knowledge of the driver's behavior or medical or physical condition, and the form must be completed in full.
  • Reasons to check include physical impairment, epilepsy or a similar condition, impaired vision, habitual use of alcohol or drugs, mental incompetence, lack of skill and repeated accidents or violations.
  • The report is not a public record. The OMV will not disclose its contents, and a driver must obtain a court order to learn who filed it.
  • The printed form, dated R 7/05, is titled Report of Driver Condition or Behavior; the OMV's web page calls it the Driver Behavior Report.

Get the official form

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

Driver Behavior Report

Fill it with Vero

If your copy of the form is a fillable PDF, upload it once and Vero Documents fills it from the visit note and the chart, ready for you to review and sign. Download, print, or email the finished form, with the patient’s consent.

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

Can a doctor report an unsafe driver in Louisiana?

Yes. The OMV lists health care providers among those who may file DPSMV 3005, along with courts, law enforcement agencies, OMV employees and family members. The report must rest on firsthand knowledge of the driver's behavior or medical or physical condition, and it must be completed in full.

Will the driver find out who reported them?

The OMV states that DPSMV 3005 is not a public record and that it will not divulge the information in the report, whether the case is open or closed. A licensed driver who wants the reporter's name must seek an order from a court of competent jurisdiction.

What happens after the OMV receives a driver behavior report?

Third-party reports are forwarded up the OMV chain of command for review. When the department suspects a physical or mental infirmity, it may investigate whether driving privileges should be suspended or denied, and the driver may need to furnish satisfactory medical statements, such as DPSMV 2302, or pass a special license exam.