[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-308683-105":3,"detail-sidebar-cat-0-en-105":81,"doc-detail-308683-en":131},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","dmv-medical-evaluation-form-mv-346-revised-82024","DMV Medical Evaluation Form MV-346 - Revised 8/20/24","","Delaware DMV MV-346 is a medical evaluation and attestation form used to assess whether a customer’s health conditions may impair safe driving. It requests self-reported health change information, detailed screening across neuropsychological, neurological, orthopedic, pulmonary/cardiovascular, endocrine/diabetes, vision/hearing, medications/drugs or alcohol, and other medical issues, with required explanations for positive findings. It also includes licensed practitioner recommendations on driving eligibility, conditions for DMV follow-up, license suspension timing, possible re-exam requests, practitioner certification, and submission details by mail or fax/email.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/dmv-medical-evaluation-form-mv-346-revised-82024/308683/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/dmv-medical-evaluation-form-mv-346-revised-82024/308683.png","ImageObject",300,407,{"name":42,"@type":43},"Mason","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-21","2026-09-20",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",12,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What medical areas does the form ask about to evaluate driving safety?","Question",{"text":63,"@type":64},"The form covers neuropsychological and cognitive impairment, neurological episodes, orthopedic and muscular problems, pulmonary/cardiovascular issues, endocrine/diabetes symptoms, vision/hearing concerns, drugs or alcohol and addiction-related issues, and other medical conditions that could decrease driving ability.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"What does a “YES” recommendation allow, and what choices must be marked?",{"text":68,"@type":64},"A “YES” recommendation must specify whether the physician certifies adequate control of loss of consciousness episodes or, if a non-physician practitioner, that there have been no such episodes in the last three months and no elevated driving risk. It also requires selecting whether treatment is ongoing for DMV follow-up or whether further evaluation is unnecessary.",{"name":70,"@type":61,"acceptedAnswer":71},"How should the form be submitted to the DMV Medical Section?",{"text":72,"@type":64},"The form can be mailed to DMV – Medical Section, PO Box 698, Dover, DE 19903-0698, or transmitted electronically using the provided fax number and email address targeting the Medical Records Section.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},308683,1789871659,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,120,123,127],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":116,"doc_module":4,"doc_module_name":25,"category_name":117,"show_sort_weight":118,"slug":119},9,"Religion & Spirituality",20,"religion-spirituality",{"id":118,"doc_module":4,"doc_module_name":25,"category_name":121,"show_sort_weight":118,"slug":122},"World Cup","world-cup",{"id":124,"doc_module":4,"doc_module_name":25,"category_name":125,"show_sort_weight":124,"slug":126},10,"Lifestyle","lifestyle",{"id":128,"doc_module":4,"doc_module_name":25,"category_name":129,"show_sort_weight":97,"slug":130},19,"General","general",{"code":4,"msg":82,"data":132},{"doc_id":79,"user_id":133,"nickname":42,"user_avatar":134,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":26,"language":140,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":12,"update_tm":80,"read_time":97},5909887256941,"https://ap-avatar.wpscdn.com/davatar_9964176cb1d06d4a9deccf72a44ae3dc","To ensure the safety of all individuals, customers should self-report any changes in their health that might affect their ability to drive.  \nNAME: DATE OF BIRTH: LICENSE \\#  \n\n| ADDRESS: |  |  |  |\n| --- | --- | --- | --- |\n| MEDICAL HISTORY\u003Cbr>NEUROPSYCHOLOGICAL: Is there any evidence of a psychological ptoblem or cognitive impairment (such as dementia) which may affect driving? | Yes No Not Assessed |  |  |\n|  | | | |\n| NEUROLOGICAL: Are there any transient neurological problems (such as spells of mental clouding, seizures, convulsions, transient ischemic attacks, or vertigo) or more unchanging problems (such as stroke, traumatic brain injury, or Parkinson’s Disease) which may impair driving?\u003Cbr>ORTHOPEDIC AND MUSCULAR: Are there any problems with bones, joints, or muscle weakness,(such as impairment of a hand or foot) which may affect driving?\u003Cbr>Is the use of adaptive equipment required to safely operate a motor vehicle?\u003Cbr>PULMONARY/ CARDIOVASCULAR: Are there any problems with the lungs or heart which may affect driving (such as shortness of breath, fatigue, syncope, or other arrhythmias?)\u003Cbr>ENDOCRINE-DIABETES: Are there any symptoms which may affect driving,(such as episodes of confusion, loss of consciousness or vision changes?)\u003Cbr>VISION/ HEARING: Do you think vision or hearing may be too impaired to drive safely?\u003Cbr>DRUGS AND/OR ALCOHOL: Does the customer describe a problem with addiction, habituation, or alcoholism? If so, is there documented evidence of these problems which may prevent safe driving?\u003Cbr>OTHER MEDICAL: Does the customer suffer from any other condition or disease which may decrease their ability to safely operate a motor vehicle? | | | |\n| If YES, to any of the above, please explain with a diagnosis, and a date of the most recent episode |  |  |  |\n\nYes No  \nMEDICATIONS: Is the customer prescribed medications which may affect their ability to drive? If YES, list medications below  \nAs of August 2024, DMV no longer requires mandatory reporting of medical conditions. Licensed practitioners are encouraged to report patients who may pose a danger driving.  \nMV-346 – Revised 8/20/24 Document No. 45-07-93-03-01  \nNAME: DATE OF BIRTH: LICENSE \\#  \nRECOMMENDATIONS:  \nYES, THE CUSTOMER SHOULD BE ALLOWED TO DRIVE (check either 1 or 2)  \n1. I am a physician, and I certify that the loss of consciousness episode(s) is under sufficient control and the customer does not have an elevated risk to safely operate a motor vehicle.  \n2. I am a non-physician licensed practitioner, and I certify the driver has not had a loss of consciousness episode(s) in the last three months and does not have an elevated risk to safely operate a motor vehicle.  \nIF YES, MARK ONE OF THE FOLLOWING  \n 1. Medical treatment for this condition is ongoing and should be followed by the DMV.  \n 2. There is no need for further medical evaluation or for the DMV to follow this condition.  \nNO, THE CUSTOMER SHOULD NOT BE ALLOWED TO DRIVE  \nNO, I believe the customer SHOULD NOT be permitted to drive. If appropriate, patient can be re-evaluated at a future time for the reinstatement of the license. Please explain your reasoning.(For example, it is too soon after a loss of awareness event) . Test results can be included.  \nYes No  \nDo you believe the customer’s license suspension should be effective immediately?  \nAre you requesting a re-exam?  \nIf requesting a re-exam, is the customer permitted to drive until reexam is scheduled?  \nLICENSED PRACTITIONER ATTESTATION:  \nHow long have you been treating this patient?   Date of last exam:   Additional comments or if there should be further evaluation from a different licensed practitioner:  \nLicensed Practitioner (name printed or typed):  \nSignature:  \n\n| License number: |\n| --- |\n| Date: |\n\nAddress:  \n\n| Phone Number: |\n| --- |\n| Fax Number: |\n\nI am an emergency, urgent care or inpatient physician. Follow up will be completed by the customer’s licensed practitioner.  \nPlease mail the form to:  \nDMV – Medic","cbCaioCN2q24aLLq","https://ap.wps.com/l/cbCaioCN2q24aLLq","pdf",425499,"English","# Medical self-report and screening questions\n## Medical condition domains\n## Medications and substance use\n# Practitioner recommendations and attestation\n## Driving eligibility decision\n## License suspension and re-exam options\n## Practitioner certification and contact details\n# Submission instructions","[{\"question\":\"What medical areas does the form ask about to evaluate driving safety?\",\"answer\":\"The form covers neuropsychological and cognitive impairment, neurological episodes, orthopedic and muscular problems, pulmonary/cardiovascular issues, endocrine/diabetes symptoms, vision/hearing concerns, drugs or alcohol and addiction-related issues, and other medical conditions that could decrease driving ability.\"},{\"question\":\"What does a “YES” recommendation allow, and what choices must be marked?\",\"answer\":\"A “YES” recommendation must specify whether the physician certifies adequate control of loss of consciousness episodes or, if a non-physician practitioner, that there have been no such episodes in the last three months and no elevated driving risk. It also requires selecting whether treatment is ongoing for DMV follow-up or whether further evaluation is unnecessary.\"},{\"question\":\"How should the form be submitted to the DMV Medical Section?\",\"answer\":\"The form can be mailed to DMV – Medical Section, PO Box 698, Dover, DE 19903-0698, or transmitted electronically using the provided fax number and email address targeting the Medical Records Section.\"}]","DMV Medical Evaluation Form MV-346 - Revised 8/20/24 | PDF"]