DS 699A Form – The DS 699A form (officially titled Self Referral for Reevaluation of Driving Skill) is an official California DMV document that allows licensed drivers to voluntarily request a review of their own driving ability. Updated in October 2024 (REV. 10/2024), this simple one-page PDF helps safety-conscious drivers proactively address concerns about their driving skills before an incident occurs.
Whether you’re experiencing age-related changes, recovering from an injury, or simply want peace of mind, the DS 699A form is the fastest way to start the official reevaluation process with the California DMV.
What Is the DS 699A Form?
The DS 699A Self Referral for Reevaluation of Driving Skill is a voluntary form designed exclusively for drivers who want the DMV to reassess their ability to drive safely. Unlike the DS 699 (used by family members, physicians, or law enforcement to report another driver), the DS 699A is a self-referral.
By submitting this form, you are asking the DMV to:
- Review your driving record
- Possibly require a vision test, written knowledge test, and/or behind-the-wheel driving test
- Request medical information from you or your physician if needed
Important Note from the DMV: Submitting the DS 699A initiates a formal reexamination of your licensing qualifications. This process may result in restrictions, suspension, or revocation of your driving privilege if the DMV determines you no longer meet safety standards.
Who Should Use the DS 699A Form?
The DS 699A is ideal for:
- Older drivers concerned about slower reaction times or vision changes
- Drivers recovering from medical conditions (stroke, surgery, medication side effects)
- Anyone who has noticed personal driving difficulties (getting lost, misjudging distances, etc.)
- Responsible drivers who prefer to self-refer rather than wait for an external report
It is not required by law — it is completely voluntary and shows proactive commitment to road safety.
How to Download the Official DS 699A PDF (Free & Current)?
The most current version of the form (REV. 10/2024) is available directly from the California DMV:
Direct Download Link:
https://www.dmv.ca.gov/portal/uploads/2024/11/DS-699-A-R10-2024-ASB-WWW.pdf
Always download from the official DMV website to ensure you have the latest revision. The form is a fillable PDF that works on any device.
Step-by-Step Guide: How to Fill Out the DS 699A Form
The DS 699A is intentionally simple and takes less than 5 minutes to complete:
- Print or open the PDF on your computer/phone.
- Fill in your personal information:
- Full Name
- Driver License Number
- Date of Birth
- Telephone Number
- Complete Address (Street, City, State, ZIP Code)
- Optional section: “I am requesting this reevaluation because…” — briefly explain your reason (highly recommended for faster processing).
- Sign and date the form.
- Save a copy for your records.
No additional documents are required to submit the form itself.
How to Submit the DS 699A Form to the California DMV?
You have two easy options (updated 2024 instructions):
Option 1 – Email (Fastest)
Send the completed form to:
[email protected]
Option 2 – Mail (choose based on your location):
- 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
You may also drop it off in person at any DMV field office, but email or mail is preferred.
What Happens After You Submit the DS 699A?
After the DMV receives your DS 699A:
- They will contact you by mail or phone.
- You may be scheduled for a vision screening, written test, and/or driving test.
- Medical information may be requested.
- The entire process is confidential and handled by the Driver Safety branch.
The goal is to ensure every California driver remains safe behind the wheel — including yourself.
DS 699A vs. DS 699: Key Differences
| Form | Purpose | Who Submits | Used For |
|---|---|---|---|
| DS 699A | Self-referral | You (the driver) | Voluntary reevaluation |
| DS 699 | Third-party referral | Family, doctor, police | Reporting another driver |
Frequently Asked Questions (FAQs) About DS 699A
Is the DS 699A form free?
Yes — completely free to download and submit.
Will submitting DS 699A affect my insurance?
The DMV does not automatically notify your insurance company, but any resulting license action (suspension/restriction) could affect rates.
Can I withdraw my request?
Once submitted, the reevaluation process typically proceeds, but you can contact Driver Safety for more information.
Is there a deadline to submit?
No — you can submit the DS 699A at any time.
Final Thoughts: Take Control of Your Driving Safety
The DS 699A Self Referral for Reevaluation of Driving Skill is a powerful tool for responsible California drivers who want to stay safe on the road. By proactively requesting a review, you demonstrate maturity and concern for public safety.
Download the latest DS 699A PDF today and take the first step toward safer driving:
→ Official DS 699A Form (REV. 10/2024)
For the most accurate and up-to-date information, always refer to the official California DMV website at dmv.ca.gov. Safe driving starts with responsible decisions — and the DS 699A form is one of the best.