SCDMV VS-004C Ignition Interlock Medical Exemption

South Carolina drivers who believe a medical condition prevents them from using an ignition interlock device (IID) start with this certification. A pulmonary physician answers whether the driver has normal lung capacity to blow into a device for 5 seconds or, failing that, enough for 2.5 seconds. A vendor approved by the Department of Probation, Parole and Pardon Services then tests whether the driver can give a measurable sample.

Who completes it

The driver completes Section I; a pulmonary physician completes and signs Section II with a professional license number; the IID vendor representative completes Section III.

Submitting and payment

How to submit it
After the physician signs, the driver takes the form to a vendor from PPP's pre-approved list for testing, and the completed form is returned to SCDMV.

Good to know

  • Only a pulmonary physician may complete Section II; the form makes no provision for another specialty to certify.
  • The physician answers two yes/no questions only: normal lung capacity for a 5-second breath into a device, and if not, enough capacity for 2.5 seconds.
  • The physician's answer is not the final word: the vendor records whether the driver could or could not provide a measurable breath sample.
  • Drivers who can provide a measurable breath sample must have the IID installed in a vehicle.

Get the official form

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

Ignition Interlock Medical Exemption Certification

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 South Carolina's ignition interlock medical exemption?

Only a pulmonary physician. Section II is titled Pulmonary Physician Certification and asks for the physician's name, professional license number, signature and date, along with the two lung capacity answers.

Does the doctor's certification exempt the driver from the IID?

Not by itself. After Section II, the driver submits the form to a vendor pre-approved by the South Carolina Department of Probation, Parole and Pardon Services, which determines whether the driver can operate an IID. If the driver gives a measurable breath sample, the device must be installed.

What breath durations does VS-004C ask about?

Whether the driver shows normal lung capacity to blow into a device for 5 seconds and, if not, whether they have enough lung capacity to blow for 2.5 seconds. Both are yes/no questions answered in the physician's medical opinion.