This physician's certificate lets the Indiana Bureau of Motor Vehicles hear directly about a medical impairment that affects a patient's ability to drive, and the BMV weighs it in licensing decisions. It sits among the BMV's driver's license and permit forms, next to the Request for Driver Ability Review (State Form 54750) and the vision certificates.
A physician completes the certificate.
Download the current version from the source each time; forms change without notice.
Physician's Certificate of Medical Impairment
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No. State Form 50018 is the Physician's Certificate of Medical Impairment listed among the BMV's license and permit forms. When the Driver Ability Department opens a review, it sends a separate Medical Review Form, State Form 54747, which the driver's primary care or treating physician must complete.
Any medical professional can request a review on State Form 54750, Request for Driver Ability Review, completed in full and sent by mail, email or fax. The Driver Ability Department will not process anonymous requests and notifies the driver by mail if a review is warranted.