Oklahoma Epilepsy Designation Enrollment Form

Oklahomans diagnosed with epilepsy can voluntarily add an epilepsy designation to their driver license or state ID record to help law enforcement officers and emergency medical professionals identify and communicate with them. Service Oklahoma requires a provider's signed certification of the diagnosis. The individual then chooses whether the designation is displayed on the credential, shared with law enforcement, or both.

Who completes it

A licensed primary care physician, licensed psychologist or licensed psychiatrist completes Section 2, the Provider Certification of Diagnosis. The individual completes the identity, election, emergency contact and acknowledgment sections and signs.

Submitting and payment

How to submit it
The individual submits the completed form to Service Oklahoma; the provider only signs the certification.

Good to know

  • Requested under 47 O.S. §6-130, the designation is voluntary and is not required to obtain or renew a driver license or state ID card.
  • This designation is separate from any medical review of seizure fitness to drive; the form asks nothing about seizure control or driving ability.
  • Section 4 collects only an optional emergency contact name and phone number, which is accessible to law enforcement officers.
  • The individual can update or remove the designation at any time. A parallel Autism Designation Enrollment form uses the same provider section.

Get the official form

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

Epilepsy Designation Enrollment

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 Oklahoma epilepsy designation form?

A licensed primary care physician, licensed psychologist or licensed psychiatrist completes Section 2, certifying that the individual has been diagnosed with epilepsy and giving printed name, license type, license number, signature and date.

Is the epilepsy designation a fitness-to-drive report?

No. The provider only certifies the diagnosis; the form asks nothing about seizure frequency, control or driving safety. It exists for the limited purpose of helping law enforcement officers and emergency responders identify and communicate with the individual.

How is the epilepsy designation shown?

In Section 3 the individual picks one option: displayed on the credential, communication considerations shared with law enforcement, or both, and confirms the voluntary request under 47 O.S. §6-130. The individual can later update or remove it.