NYS DMV Form DS-6. Physician's Reporting Form

NYS DMV Form DS-6, known as the Physician's Reporting Form, is utilized by licensed physicians to notify the New York State DMV about a driver licensed in NYS when the physician determines that the driver's mental or physical condition can affect the safe operation of motor vehicles. This form plays a crucial role in ensuring road safety by reporting medical conditions that may impair a person's ability to drive safely.

The form consists of sections where the physician provides their personal information, including name, address, and license number. The important fields in this form include the details of the driver, such as their name, date of birth, and driver's license information. The physician is required to describe the medical condition, provide the diagnosis, and explain how it may impact the driver's ability to operate a motor vehicle safely.

When completing this form, it is important for the physician to provide accurate and comprehensive information, including supporting medical documentation, to facilitate the DMV's evaluation and decision-making process regarding the driver's fitness to drive. Medical professionals must comply with relevant privacy and confidentiality regulations when handling sensitive patient information.

Application Example: A licensed physician in New York State diagnoses a patient with a medical condition that may impede their ability to drive safely and determines that it is necessary to report the condition to the DMV. The physician would complete Form DS-6, providing their personal information, the driver's details, and a thorough explanation of the medical condition and its potential impact on driving. This form helps ensure that the DMV is aware of any medical conditions that may affect a person's ability to drive safely and allows them to take appropriate actions, such as license restrictions or medical evaluations.

Related Forms: Form DS-7, Medical Evaluation Request, is a related form that can be used in conjunction with Form DS-6. If the physician believes that a driver's medical condition requires further evaluation, they may submit Form DS-7 to request a medical evaluation by the DMV's Medical Review Unit. This form provides additional details about the driver's condition and any recommended restrictions or accommodations.