Florida HSMV Form 72423 Medical Report Guide

What Is Florida HSMV Form 72423?

HSMV Form 72423 is the official Medical Report used by the Florida Department of Highway Safety and Motor Vehicles. The form (effective 07/18) is referenced in Florida Administrative Code rules 15A-5.004, 15A-5.005, 15A-5.006, 15A-5.008, and 15A-5.009.

It collects detailed information from a physician about a driver’s medical history, current conditions, medications, and functional limitations that could impact safe driving. The completed report is reviewed by the Medical Advisory Board, a panel of physicians that advises FLHSMV on medical criteria and vision standards for driver licensing.

You can download the official form directly from the Florida Department of Highway Safety and Motor Vehicles website: Download Florida HSMV Form 72423 (PDF).

When Is the Medical Report Required?

FLHSMV may request Form 72423 after receiving a report that a licensed driver or applicant may have a medical condition that could interfere with safe driving. Reports can come from:

• Physicians or other healthcare providers
• Law enforcement officers
• Courts
• Other state agencies
• Concerned family members or citizens

Under Florida Statute 322.126, any person or agency with knowledge of a mental or physical disability that may affect driving ability is authorized to report it. These reports are confidential, and no civil or criminal action can be taken against the person who submits the information in good faith.

Common conditions that may trigger a medical review include epilepsy or seizures, loss of consciousness, diabetes with hypoglycemia, cardiac issues, progressive neurological diseases, significant vision problems, sleep disorders, cognitive impairments, and substance use concerns.

The goal of the Medical Review program is not to stop people with medical conditions from driving, but to confirm that the condition does not interfere with the safe operation of a motor vehicle.

How the Florida Medical Review Process Works?

Once FLHSMV decides a review is needed, the driver receives written notice and must submit medical information from a physician within 45 days. Failure to respond can result in suspension or revocation of driving privileges.

Key steps in the process include:

1. FLHSMV notifies the driver of the medical review requirement.
2. The driver takes Form 72423 to the physician most familiar with their medical history.
3. The physician completes the form in full and provides a recommendation on whether the patient can safely drive.
4. The completed form is mailed or faxed directly to the Medical Review Program in Tallahassee.
5. The Medical Advisory Board reviews the report and issues a recommendation.
6. FLHSMV makes a final decision within 90 days of receiving all requested information and notifies the driver in writing.

Possible outcomes include unrestricted approval, approval with follow-up reports or restrictions, requirements for vision, knowledge, or driving skills retesting, or denial of driving privileges if the condition poses a safety risk.

Drivers may submit updated medical information or a Certified Driver Evaluation at any time for reconsideration.

Sections Included on Form 72423

The form is comprehensive and covers multiple medical areas. Physicians must complete every applicable section or mark “N/A” where appropriate. Major sections include:

• History – Length of physician-patient relationship, other treating doctors, medical conditions, prescribed medications, and reliability in taking medication.
• Neurological – History of epilepsy or seizures, last seizure date, medications, blood levels, progressive neurological diseases, and residual deficits.
• Loss of Consciousness/Dizziness – Blackouts, fainting, or dizziness episodes, causes, and frequency.
• Psychiatric – Hospitalizations or treatment for mental or emotional illness and current status.
• Mental/Cognitive – Memory loss, organic brain syndrome, confusion, and results of Mini-Mental State Exam (MMSE) or Montreal Cognitive Assessment (MoCA) if applicable.
• Alcohol and Drug – Evidence of addiction or abuse, treatment history, and current use.
• Diabetes – Type of diabetes, episodes of ketoacidosis or hypoglycemia with loss of consciousness, and overall control.
• Cardiac – Heart conditions that could interfere with driving, related loss of consciousness, and treatment status.
• Musculoskeletal – Limitations of motion, weakness, paralysis, and whether adaptive equipment or a Certified Driver Evaluation would help.
• Sleep Disorder – Frequency and treatment of sleep apnea, narcolepsy, or insomnia.
• Visual – Visual acuity with and without correction, field of vision, and use of prism lenses.

The final section asks the physician for a clear yes-or-no opinion on whether the individual can safely operate a motor vehicle, along with an explanation.

How to Complete and Submit HSMV Form 72423?

Instructions for the driver: Take the form to the physician who knows your medical history best. Provide accurate personal information (name, driver license number, date of birth, and telephone number).

Instructions for the physician: Complete the form thoroughly. Attach supporting documents such as EEG results, cognitive test scores, or specialist reports when requested. Sign, print your name, include your medical license number, specialty, address, telephone number, and the date.

Submit the completed form only to the Medical Review Program (do not return it to a local tax collector or driver license office):

Mail to:
Bureau of Motorist Compliance
Medical Review Program
Neil Kirkman Building, MS 86
Tallahassee, Florida 32399-0500

Fax to: 850-617-3944
Telephone: 850-617-3814

Keep a copy of the completed form for your records. Extensions may be available on a case-by-case basis by contacting the Medical Review Section.

Download the Official Florida HSMV Form 72423

Always use the current official version from the Florida Department of Highway Safety and Motor Vehicles to avoid processing delays.

Download HSMV Form 72423 – Medical Report (PDF)

You can also find related forms and resources on the official FLHSMV forms page and Medical Review section of the website.

Additional Resources and Helpful Links

• FLHSMV Medical Review Program Overview
• The Medical Review Process
• Report an Unsafe Driver (Form 72190)
• Official FLHSMV Forms Directory
• Florida Statute 322.126 – Report of Disability

Frequently Asked Questions

Can I get an extension to submit the form?
Extensions are considered on a case-by-case basis. Contact the Medical Review Section at 850-617-3814 as soon as possible.

What if my doctor recommends against driving?
FLHSMV will consider the physician’s recommendation along with the full medical report and any other evidence. You may later submit updated records or a Certified Driver Evaluation for reconsideration.

Is the information confidential?
Yes. Reports submitted under Florida Statute 322.126 are confidential and used solely to determine driving qualifications.

Can I still drive while the review is pending?
You may continue driving until you receive a formal decision from FLHSMV, unless your privilege has already been suspended or canceled for another reason. Always follow any temporary instructions in the notice letter.

Final Thoughts

Florida HSMV Form 72423 plays an important role in balancing individual mobility with public safety on the state’s roads. Completing the form accurately and promptly with your physician’s full cooperation gives the Medical Advisory Board the information it needs to make a fair recommendation.

Download the official form today, schedule an appointment with your doctor, and submit the completed report by the deadline listed in your notice letter. For the most current information, always refer to the official Florida Department of Highway Safety and Motor Vehicles website.