New York clinicians use this one-page form to tell the DMV Medical Review Unit about a driver whose physical or mental impairment may affect safe driving. It identifies the driver, describes the condition and medications, and records the clinician's opinion: either the patient should be evaluated by DMV, or the condition prevents safe driving and privileges should be suspended.
A licensed physician, physician assistant or nurse practitioner completes all three parts (driver identification, description of the condition, and the practitioner's own identification and certification), then signs and dates the form.
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Physician's Reporting Form
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No. New York has no mandatory physician reporting, so DS-6 is a voluntary report. Once a report arrives, DMV may suspend the license until a physician certifies the condition is controlled, and DMV does not reveal the identity of a person who reports a driver's medical condition in response to a FOIL request.
It must be completed and signed by a licensed physician, physician assistant or nurse practitioner. Part 3 asks for the practitioner's certificate or license number, specialty, mailing address, state where licensed and telephone number, then a full signature and date.
Yes. After choosing whether the patient should be evaluated by DMV or whether driving privileges should be suspended, Part 2 lets you give further detail in the space provided or in an attached statement on your letterhead.