Patient Advisory Form Medical Fitness Assessment to Drive (Ireland)

Form Template

When a patient has been diagnosed with a medical condition that may impact their ability to drive safely, their doctor will issue a Patient Advisory Form.

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Medical conditions that may impact the ability to drive include Alzheimer's disease, dementia, vision loss, hearing loss, stroke, and more. Any condition that will impact reaction time or cognitive impairment will require further evaluation, and driving privileges may be suspended until the test is completed. The Patient Advisory Form Medical Fitness Assessment to Drive (Ireland) app should be completed by a doctor who has diagnosed a medical condition that questions the individual's fitness to drive. It will require that the driver contact the proper motor vehicle authority to notify them of the medical condition. Safe driving is important to keep everyone safe, and drivers should adhere to the advice of medical professionals.

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