DS 699 Form – If you’re concerned about a loved one, neighbor, or other driver in California who may no longer drive safely due to medical issues, age-related decline, or dangerous habits, the DS 699 Form (Request for Driver Reexamination) is the official way to alert the California Department of Motor Vehicles (DMV). This form triggers a professional review of the driver’s qualifications to help protect public safety while maintaining fairness in the licensing process.
The latest version—DS 699 (REV. 10/2024)—is available as a free, printable PDF directly from the DMV. Below you’ll find everything you need: what the form does, who can use it, how to complete and submit it, and step-by-step guidance.
What Is the DS 699 Form?
The DS 699 Form, officially titled “Request for Driver Reexamination,” is a California DMV document used to ask the department to reevaluate a driver’s ability to operate a vehicle safely.
It is not a self-referral form (that’s DS 699A). Instead, it allows third parties—family members, friends, caregivers, physicians, law enforcement, vision specialists, or any concerned citizen—to report specific concerns about another driver’s physical, mental, or behavioral fitness.
The DMV uses the information to determine whether further testing (vision, written, or driving exam) or other actions are needed under California Vehicle Code provisions.
Why the DS 699 Form Matters for Road Safety?
California roads see thousands of collisions each year linked to medical conditions, cognitive decline, or impaired reactions. The DS 699 form gives the public a direct, confidential channel to flag issues such as:
- Dementia or confusion
- Vision problems
- Seizures or blackouts
- Medication side effects
- Poor coordination or slow reactions
- Aggressive or erratic driving behaviors
Submitting the form helps the DMV fulfill its legal duty to investigate when a driver’s record or condition may pose a risk.
Who Can Submit a DS 699 Request for Driver Reexamination?
Anyone can submit the form. Common submitters include:
- Relatives or family members
- Friends or caregivers
- Physicians or vision specialists
- Law enforcement officers
- Courts
You do not need to be related to the driver, and the DMV honors confidentiality requests to the fullest extent possible.
How to Download the DS 699 Form PDF (Latest Version)
Direct official download link (REV 10/2024):
Download DS 699 Form PDF
This is the current fillable/printable version hosted on the California DMV website. Always use this link to ensure you have the most up-to-date form.
Step-by-Step Guide to Completing the DS 699 Form
- Driver Information – Provide the full name, date of birth (or approximate age), driver license number, address, and vehicle plate number (if known).
- Reason for Reexamination – Check applicable boxes for medical, physical, mental, vision, or behavioral conditions. Use the detailed checklist for specific driving errors (e.g., drifting lanes, failing to yield, getting lost near home).
- Description – Clearly describe the condition or observed behaviors in the space provided. Include any known medical diagnoses or medications.
- Your Information – Print your name, relationship to the driver, contact details, and sign the form. Unsigned forms are not accepted.
- Confidentiality – Check the box if you want your name kept confidential.
All fields marked with an asterisk (*) are required.
Where and How to Submit the Completed DS 699 Form?
Submit by email or mail only (do not submit in person at a regular DMV field office):
- Email: [email protected]
- Mail (choose by county):
- Northern California (North of Fresno County): Sacramento Driver Safety, 4700 Broadway, 2nd Floor, Sacramento, CA 95820-1501
- Southern California (South of Fresno County): El Segundo Driver Safety, 390 N. Pacific Coast Highway, Ste. 2075, El Segundo, CA 90245-4470
Keep a copy for your records. The DMV will review the submission and may contact the reported driver for a reexamination.
What Happens After You Submit the DS 699 Form?
Once received, the DMV’s Driver Safety branch evaluates the request. Possible outcomes include:
- Request for medical information from the driver or their physician
- Vision, written, or behind-the-wheel test
- Reexamination hearing (in-person, phone, or video)
- No action, restriction, or suspension of driving privileges (if warranted)
The process focuses on facts and safety, not age alone.
DS 699 vs. DS 699A (Self-Referral)
- DS 699 → Report concerns about someone else.
- DS 699A → Voluntary self-referral if you want the DMV to review your own driving ability.
Both forms are available on the DMV website, but they serve different purposes.
Frequently Asked Questions (FAQs) About DS 699 Form
Is the DS 699 form anonymous?
You may request confidentiality. The DMV honors this to the fullest extent allowed by law.
Can a doctor use DS 699?
Yes. Physicians are among the most common and credible submitters.
How long does the reexamination process take?
It varies, but the DMV typically notifies the driver within weeks and schedules any required tests or hearings promptly.
Will the driver know who submitted the form?
Only if you do not request confidentiality.
Is there a fee to submit DS 699?
No. The form and submission are free.
Download the Official DS 699 Form Today
Protecting California drivers starts with awareness and action. If you have safety concerns, download the latest DS 699 (REV 10/2024) form here:
Download DS 699 Request for Driver Reexamination PDF
For more information on the DMV reexamination process, visit the official California DMV pages on deteriorated driving skill and driver safety.
Stay safe on the road – use the DS 699 form responsibly.