PA DOT Form DL-122 DS. Diabetic Form

The Diabetic Form (DL-122) is a document required by the Pennsylvania Department of Transportation for individuals with diabetes who wish to obtain or renew a driver's license. This form is designed to gather medical information related to diabetes management and control.

It consists of sections where applicants must provide details about their diabetes diagnosis, treatment regimen, and any associated complications. Additionally, the form requires information about the attending physician responsible for the applicant's diabetes care.

It is crucial to complete this form accurately and honestly, as it helps assess an individual's ability to safely operate a motor vehicle while managing their diabetes. The information provided on this form assists the Department of Transportation in determining whether additional medical evaluations or restrictions are necessary for licensing purposes.