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Achilles Neurology

The request usually arrives as a letter from a DMV Driver Safety Office with a Driver Medical Evaluation, form DS-326, enclosed, a return address or fax number printed on it, and a date to return it by. Behind the letter is something the DMV has learned: a physician's report of a seizure or a blackout, a crash or a police referral, a concern raised by a family member, or a yes answer to the health questions at renewal. At an in-person visit of about 60 minutes, Dr. Ntranos examines you and completes the physician sections of the form, and in most cases you leave with it. The DMV, not our office, decides about your license.

What a DMV neurological evaluation is

The DMV calls it a Driver Medical Evaluation. When the condition behind it is neurological, such as a seizure, a fainting spell, a stroke, or a memory problem, it makes sense for a neurologist to complete it. The form asks what the diagnosis is, whether it is stable, and what the medications are. It also asks whether there has been a lapse of consciousness and when, and whether the condition currently affects safe driving.

Three things happen at the visit. Dr. Achillefs Ntranos, MD, a board-certified neurologist, takes your history and reviews your records. He examines you. He then completes Sections 5 to 13 of the form from what he found. It is an evaluation rather than an advocacy letter: the form asks for facts and a clinical opinion, and for a driver with a stable, well-treated condition that is usually exactly what is needed.

Blank medical form and reflex hammer beside a steering wheel.

The medical part of a driving review

  • History: document events, treatment and the condition's stability.
  • Examination: assess relevant neurological function in person.
  • Decision: the DMV decides the license outcome.
The evaluation supplies neurological information for the DMV to review.

The DS-326 Driver Medical Evaluation form

The DS-326 is a five-page form. Page 1 is yours. Pages 2 to 5 belong to the physician. If you need another copy, the DMV publishes a blank DS-326 form, but a downloaded form has an empty return box, so the details of where to send it come only from the form the DMV mailed you or from your notice.

Part of the formWho completes itWhat it asks
Sections 1 to 3, page 1You, before the visitYour details and license number, a health history checklist with an explanation of any yes answers, your signature, and an authorization for your physician to release information to the DMV
Sections 5 to 7The physicianVision, any other treating clinicians, the diagnosis and prognosis, the medications, and whether the condition or its treatment currently affects safe driving
Sections 8 to 11The physician, where they applyFunctional impairments, dementia or cognitive impairment ratings, lapse of consciousness disorders with the date of the last episode, and diabetes
Sections 12 and 13The physicianAdditional comments, signature, specialty, and license number

Two boxes at the top of page 1 matter more than anything else on the form: "Physician return form to" and "Return by". The DMV fills those in before mailing the form to you.

Where to send the DS-326 form

Send it to the Driver Safety Office named in the return box on page 1 of the form the DMV mailed you, by fax or by mail, using the number or address printed there. There is no single statewide address. The office and the fax number depend on where you live, which is why searching for one online gives conflicting answers. If you downloaded a blank DS-326 from the DMV website instead, the return details are on the notice letter itself. Keep a copy of the completed form.

If the notice or the return box is lost. Do not send the form to an address found in a search. Contact the DMV with your full name, date of birth and driver's license number, ask which Driver Safety Office is handling your case and where it wants the form, and write those details on the form before it goes. Fax it if you can and keep the fax confirmation page with your copy, because it shows the date the form went in.

Who submits it is your choice. Some patients send the completed form themselves, so they hold the original and the fax confirmation. Others ask our office to send it on their behalf, and we do that the same day and give you a copy. Say which you prefer at the visit.

Your deadline

Your notice states the date the DMV wants the form back. Follow that date. Some online sources refer to a window of about 24 days from the notice, but the date on your own notice is the one that applies to you, and the "Return by" box on page 1 is where to find it. If the deadline is close, tell us when you request the visit. Appointments are usually available the same or the next business day, and in most cases the completed form leaves the office with you.

If the date has already passed, act now rather than waiting for another letter. The DMV may already have suspended your license, or may be about to. Call the Driver Safety Office named on your notice, tell them the evaluation is booked or done, and send the completed form as soon as you have it, since the DMV cannot take your evaluation into account until the form arrives.

Who needs a DMV medical evaluation

You need one when the DMV asks for one. It is not something you apply for on your own; it follows a report or a concern. The neurological conditions that most often lead to a request are:

  • A seizure, or a diagnosis of epilepsy. California physicians are required to report a diagnosis of a disorder characterized by lapses of consciousness to the local health officer, who forwards it to the DMV.
  • Fainting, blackouts, or any other episode of altered awareness, including those caused by a heart rhythm problem.
  • A stroke or head injury with lasting weakness, visual loss, or slowed thinking.
  • Memory or thinking changes, or a diagnosis of dementia. Our memory loss page covers how those are evaluated.
  • A neuromuscular or movement disorder affecting strength, coordination, or reaction time.
  • Diabetes with neurological complications, such as neuropathy or episodes of low blood sugar.

Sometimes the person who prompted the evaluation was your own doctor, filing a required report. That is a legal duty rather than a judgment about you, and a good evaluation is the route back.

The DS-326 is for a standard California driver's license. Commercial drivers are examined under federal rules by a medical examiner listed on the FMCSA National Registry, a different process and a different form.

Seizures, blackouts and the DS-326

When the request follows a seizure or a blackout, often because a physician's report has reached the DMV as described above, the form deals with it in its lapse of consciousness section. That section asks for:

  • the date of your last episode
  • your treatment, and whether you take it as prescribed
  • test results such as an EEG, a recording of the brain's electrical activity

The DMV weighs those answers against its lapse of consciousness guidelines, which set how long a driver should usually be free of episodes before driving and take the cause and the treatment into account. That is why the date of your last episode matters so much, so bring the records that show it. If you have epilepsy, bring your most recent neurology notes and EEG report as well, because the form asks the physician how well the seizures are controlled.

Where to get a DMV medical evaluation in Los Angeles

The physician sections of the DS-326 may be completed by a physician, a physician assistant or an advanced practice registered nurse, so your regular clinician is one option. A neurologist is the right choice when the reason for the request is neurological, such as seizures, blackouts, memory or thinking changes, or the lasting effects of a brain injury, because the form asks in detail about the diagnosis, its stability and the medications.

Dr. Ntranos sees DMV evaluations at both of our offices:

  • Beverly Hills: 433 N Camden Dr, Ste 610, Beverly Hills, CA 90210
  • West Los Angeles: 11620 Wilshire Blvd, Ste 600, Los Angeles, CA 90025

The evaluation is in person only, because the DMV asks for an examination. Appointments are usually available the same or the next business day, and no referral is needed. Bring the DMV notice, the form with Sections 1 to 3 completed and signed, your medication list and your records; the steps below say which records help most.

What to expect during your evaluation

  1. Before you come

    Complete and sign Sections 1 to 3 on page 1. Bring the DMV notice, the form, and a list of your medications. Records from the clinician who treats the condition help most: neurology notes, a hospital discharge summary, EEG or MRI reports, recent blood work, and, for seizures or blackouts, the date of your last event. Images can be uploaded through our patient tools page.

  2. The history

    What happened, when, and how often; what treatment you have had and whether you take it as prescribed; the date of the last episode; and what has changed since. These are the form's own questions, in its order.

  3. The examination

    Vision, eye movements, strength, sensation, reflexes, coordination, and walking, plus a bedside assessment of attention and memory when the condition calls for it. For cognitive cases the form asks the physician to rate specific domains, and when a bedside screen cannot answer that fairly we arrange neuropsychological testing first.

  4. The form

    Completed and signed at the visit in most cases. If a result is still pending, such as a recent EEG or a medication level, the form waits for it, because a form with blanks tends to come back with questions.

  5. Afterwards

    You leave with the completed original and a copy. Submit it yourself or ask us to send it. If the DMV writes back with a question, we answer it in writing.

Envelope, medical-record folder and blank calendar beside a car key.

Preparing your DMV documents

  • Your section: complete and sign the patient portion of the form.
  • Your records: bring the notice, medication list and relevant test reports.
  • Return details: follow the deadline and Driver Safety Office printed on your notice.
The notice and your records help the evaluation address the DMV's request.

Why the DMV asks for a neurological evaluation

Under the California Vehicle Code the DMV decides whether a medical condition is compatible with safe driving, and it cannot do that from a diagnosis alone. Lapse of consciousness disorders, dementia and cognitive impairment, diabetes, and vision conditions are the areas it has published guidelines for. The form is how a treating physician tells the DMV whether the condition is controlled, for how long, and whether the condition or its medication affects driving now. The medical information on it is confidential under the Vehicle Code.

How we handle DMV evaluations

  • What we do. Examine you in person, complete the physician sections fully, add a narrative report when the boxes cannot capture the situation, and answer any DMV follow-up in writing. When the return-by date is close, we book around it.
  • What we do not do. Decide or promise an outcome, adjust findings to suit one, complete the form by video, or evaluate commercial drivers. The DMV asks for an examination, so the visit is in person; a follow-up conversation can be by video.
  • If driving is not safe right now. The form will say so, and we talk about what would change that: a seizure-free interval, a medication adjustment, treatment of the underlying condition, or a driving rehabilitation program with an occupational therapist where that applies.

Fees and booking

Administrative evaluations such as this one are direct-pay. One flat fee covers the visit and the completed form, and the office confirms the fee when you request the visit. Insurance does not cover visits for medical certificates, so plan on paying out of pocket. We can provide a superbill on request, though claims for this kind of visit are usually denied. Any testing the evaluation needs, such as an EEG or blood work, runs through your insurance. HSA and FSA cards are accepted, and details are on our billing page.

A DMV letter is unsettling, so tell us the return-by date on your notice and we will plan around it. Request a DMV evaluation in Beverly Hills or Los Angeles, or call (310) 774-7025. The evaluation is in person only, no referral is needed, and the office confirms your request within 1 business day. If the request is from the FAA rather than the DMV, see our FAA neurological evaluation page.

Frequently asked questions

References

  1. California DMV. Medical conditions and driving.
  2. California DMV. Driver Medical Evaluation, form DS 326.
  3. California DMV. Lapse of consciousness disorders.
  4. FMCSA. National Registry of Certified Medical Examiners.
  5. Los Angeles County Department of Public Health. Reporting disorders characterized by lapses of consciousness.

Keep reading

Related pages

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