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MA RMV MAB106: Medical Evaluation Form for Drivers

When the Massachusetts RMV receives information that a driver may have a condition affecting safe driving, it asks a physician to complete MAB106. The physician describes the condition, including oxygen saturation for respiratory disease and AHA class for heart disease, the extent and control of symptoms, any seizure or loss of consciousness, and medications, then certifies whether the patient is medically qualified to drive.

Who completes it

A medical doctor licensed in Massachusetts completes the whole form after the patient signs the release authorizing disclosure to the RMV, and certifies under the pains and penalties of perjury with an NPI, or Board of Registration number if there is no NPI.

Submitting and payment

How to submit it
Send it by mail or fax to the RMV's Driver Control Unit, as printed on the form. The current version is MAB106 09/25.

Good to know

  • The certification offers four outcomes: qualified, not qualified, may need adaptive equipment or license restrictions through a competency road exam, or unable to determine with a road exam recommended.
  • If a police report is attached, the physician states whether they have read it and are aware of the reported incident involving the patient.
  • RMV standards treat oxygen saturation above 88% at rest or with minimal exertion as safe and AHA functional Class IV heart disease as disqualifying, so record both precisely.
  • Providers may also use MAB106 when a patient seeks to regain driving privileges after a severe driving-related cognitive impairment or a musculoskeletal condition preventing self-care.

Get the official form

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

Medical Evaluation Form

Official pagePDF

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

Is Massachusetts a self-reporting state for medical conditions?

Yes. Drivers must report a medical condition affecting their driving when it appears, regardless of their renewal date. MAB106 is how the RMV gets a physician's evaluation once it has information about a possible condition, and its Medical Affairs unit applies standards set with a physician Medical Advisory Board.

What if the physician cannot tell whether the patient can drive safely?

Check the box stating you are unable to determine driving ability and recommend a competency road examination. A separate option covers patients who may be safe with adaptive equipment or license restrictions, which the RMV assesses through the same road examination.

Who can complete MAB106?

Only a medical doctor licensed to practice in Massachusetts. Psychiatric conditions use the separate MAB118, which a psychiatric nurse practitioner may also complete, and seizures or other loss of consciousness use MAB108.