Consent for the Release of Confidential Information (Form #DC-088) This form is used to provide the MVA with the names of all doctors, hospitals, alcohol/drugs clinics and other programs where you have received treatment.
|Medical Waiver for Window Tint - This form is to be used by Maryland residents that have a medical necessity for window tint, and a Maryland physician indicates that they would benefit from having aftermarket window tint installed on their vehicle glass which reduces the light transmittance below the allowed 35%. The physician must be licensed to practice in Maryland and they will be required to complete a portion of this form and sign the form under penalties of perjury that the information is true and accurate.|
|Request For Removal Of Alcohol/Drug Restriction - A customer needs to use this form to request that their alcohol/drug restriction on their driver license be removed, and certify they meet the criteria to have the restriction removed.|
Treatment Provider's Report (Form #DC-118) This form is to be completed by your treatment provider (hospital, alcohol or drug clinic) and is used as an aid in determining your qualifications to drive.
Physician/Health Care Provider Report (Form #DC-119) This form is to be completed by your physician/health care provider and is used as an aid in determining the qualifications of an individual to drive.
Health Questionnaire (Form #DC-001) This form is used to provide a comprehensive medical history regarding your medical status as it related to driving.
Alcohol & Drug Use Questionnaire (Form #DC-001A) This form is used to provide a detailed alcohol/drug use history.
Physician Referral (Form #DC-220) This form is to be completed by a physician/health care provider to report concerns about medical fitness to drive.
|Self Report on Citizen Concern (Form #DC-225) Use this form to self-report a medical condition, or to make a concerned citizen report about another person's ability to drive safely.|
|Restricted Power of Attorney on Behalf of Driver (Form #DC-224) This form may be used if you want to appoint someone to receive information and take action on your behalf related to your case with the Driver Wellness and Safety Division of the MDOT MVA.|
Business Services Forms | Commercial Driver Licensing Forms | Driver Licensing Forms | Driver Record Forms | Insurance Compliance Forms | Miscellaneous Forms | Motorcycle Safety Forms | Vehicle Registration Forms | Formularios en Español