West Virginia's Division of Motor Vehicles keeps a communication disability list under WV Code 17C-13-6, so that law enforcement knows a driver or passenger may have trouble communicating. This one-page form requests inclusion on, or removal from, that list and links it to the plates of vehicles the person owns, drives or regularly rides in. A licensed clinician certifies the disability in Part II.
The applicant, or a parent or guardian on their behalf, completes Part I: personal details, include or remove, vehicle plate numbers, an optional description of the disability, and a signature. Part II is completed only by a licensed physician, psychiatrist or psychologist.
Download the current version from the source each time; forms change without notice.
Application To Be Included or Removed From Communication Disability List
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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Part II must be completed only by a licensed physician, psychiatrist or psychologist. The clinician prints their name, medical license number and license expiration date, gives a business address and phone, and signs that the patient has a communication disability or a disability that can impair communication.
No. The clinician certifies only that the patient has a communication disability or a disability that can impair communication, as the form defines them. The applicant may choose to describe the type of disability, possible symptoms and helpful measures in Part I, section E, but that section is optional.