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The form allows law enforcement, medical professionals, or concerned citizens to report specific concerns regarding a driver's medical history or physical health. It includes detailed sections for capturing driver information, reporter details, and the nature of the safety concerns, emphasizing that age is not a sole determining factor. The process requires a signed declaration under penalty of perjury to ensure the integrity of the public safety review. Completed requests are submitted to the DDS Medical Review Unit in Conyers, Georgia. The document outlines essential submission instructions and confidentiality policies, ensuring that final determinations are handled internally by the department to protect individual privacy while upholding strict road safety standards across the state.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/request-for-medical-review-georgia-department-of-driver-services-form-dds-270/308566/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/request-for-medical-review-georgia-department-of-driver-services-form-dds-270/308566.png","ImageObject",300,407,{"name":92,"@type":93},"Mali","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-21","2026-09-20",true,{"@type":102,"interactionType":103,"userInteractionCount":34},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Where should the completed medical review form be submitted?","Question",{"text":112,"@type":113},"Completed forms should be mailed or faxed to the Georgia Department of Driver Services, Medical Review Unit, P.O. Box 80447, Conyers, Georgia 30013, or faxed to 770-918-6266.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"Are anonymous requests accepted for medical reviews?",{"text":117,"@type":113},"No, the Georgia Department of Driver Services does not consider anonymous requests for medical reviews.",{"name":119,"@type":110,"acceptedAnswer":120},"Can the DDS share the final determination with the person who submitted the request?",{"text":121,"@type":113},"No, due to confidentiality regulations, the DDS cannot share the final determination with the person who submitted the request.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},308566,1790332520,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":34,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":8,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":81},2336475104362,"https://ap-avatar.wpscdn.com/avatar/22000c4c46a41b752dd?x-image-process=image/resize,m_fixed,w_180,h_180&k=1786595829695023868","Georgia Department of Driver Services  \nRequest for Medical Review  \nINSTRUCTIONS:  \n1) Please fill out this form, if you would like the Department of Driver Services (DDS) to perform a Medical Review to assess the individual's capacity to drive safely.  \n2) Mail or Fax your completed request to: Georgia Department of Driver Services/ Medical Review Unit/ P.O. Box 80447/Conyers, Georgia  \n30013. Fax number: (770-918-6266) .  \n\n| DRIVER INFORMATION |  |  |\n| --- | --- | --- |\n| DRIVER NAME: (lfirst, middle, last) |  | BIRTHDATE :(mm/dd/yyyy) |\n| DRIVER LICENSE NUMBER: |  | TELEPHONE NUMBER: |\n| RESIDENCE/HOME ADDRESS | CITY/ STATE/ ZIP CODE |  |\n| MAILING ADDRESS (if different from above address) | CITY/STATE/ZIP CODE |  |\n\nThe DDS will evaluate medical history, physical health, and any other factors that could impact the ability to safely operate a motor vehicle. It’s important to mention that age alone cannot be a determining factor. Please note that, due to confidentiality, the DDS cannot share a final determination with you.  \n\n| LAW ENFORCEMENT |  |  |\n| --- | --- | --- |\n| NAME: |  | TELEPHONE NUMBER: |\n| AGENCY NAME: | MAILING ADDRESS: |  |\n| CONCERN: |  |  |\n\n*Please include all relatedcrash or incident reports*  \n\n| MEDICAL PROFESSIONAL |  |  |\n| --- | --- | --- |\n| NAME: |  | TELEPHONE NUMBER: |\n| PROFESSION:\u003Cbr>\u003Cbr>MEDICAL: VISION: OTHER: | MAILING ADDRESS: |  |\n| UNDERLYING MEDICAL CONDITION OR DIAGNOSIS: |  |  |\n\n\n| CONCERNED CITIZEN |  |  |\n| --- | --- | --- |\n| NAME: |  | TELEPHONE NUMBER: |\n| RELATIONSHIP TO DRIVER: | MAILING ADDRESS |  |\n| CONCERN: |  |  |\n\n*Anonymous requests will not be considered*  \nBased on my observation and/or knowledge, I certify or declare under penalty of perjury under the laws of the State of Georgia that the information provided is true and correct and is in the interest of public safety.  \nSignature: Date:","cbCairaIBAg3racv","https://ap.wps.com/l/cbCairaIBAg3racv","pdf",304510,"English","# Driver Information\n# Law Enforcement Reporting\n# Medical Professional Assessment\n# Concerned Citizen Reporting","[{\"question\":\"Where should the completed medical review form be submitted?\",\"answer\":\"Completed forms should be mailed or faxed to the Georgia Department of Driver Services, Medical Review Unit, P.O. Box 80447, Conyers, Georgia 30013, or faxed to 770-918-6266.\"},{\"question\":\"Are anonymous requests accepted for medical reviews?\",\"answer\":\"No, the Georgia Department of Driver Services does not consider anonymous requests for medical reviews.\"},{\"question\":\"Can the DDS share the final determination with the person who submitted the request?\",\"answer\":\"No, due to confidentiality regulations, the DDS cannot share the final determination with the person who submitted the request.\"}]","Request for Medical Review - Georgia Department of Driver Services - Form DDS 270 | PDF",1789869663]