PennDOT Form DL-121: PA Seizure Reporting Guide – The Pennsylvania PennDOT Form DL-121, officially known as the Seizure Reporting Form, is a critical document used by licensed healthcare professionals to report patients with seizure disorders or epilepsy to the Pennsylvania Department of Transportation (PennDOT). This form helps determine whether an individual is medically qualified to safely operate a motor vehicle under Pennsylvania law.
Mandatory medical reporting protects public safety on Pennsylvania roadways. Healthcare providers must report certain medical conditions, including seizures, under Section 1518(b) of the Pennsylvania Vehicle Code. Form DL-121 is the condition-specific form designated for seizure disorder and epilepsy cases.
What Is PennDOT Form DL-121?
Form DL-121 is the official Seizure Reporting Form approved by PennDOT’s Medical Advisory Board. It is used exclusively by healthcare professionals (physicians, physician assistants, certified registered nurse practitioners, and other authorized providers) to report patients age 15 or older who have experienced a seizure or have a diagnosed seizure disorder.
The form collects detailed patient information, seizure history, treatment details, medication status, and the provider’s professional opinion regarding the patient’s fitness to drive. Accurate completion of DL-121 allows PennDOT’s Medical Unit to evaluate driving privileges and take appropriate action, which may include temporary recall, restrictions, restoration, or further examination.
You can download the current version of the form here: Download PennDOT Form DL-121 (PDF).
Current Pennsylvania Seizure Disorder Driving Regulations
Pennsylvania regulations governing seizure disorders are found in 67 Pa. Code § 83.4. The rules were updated effective March 28, 2026, reducing the standard seizure-free waiting period.
Key requirements include:
- A person with a seizure disorder is not qualified to drive unless a licensed physician reports that the individual has been free from seizures for at least 3 months immediately preceding the report, with or without medication.
- Experiencing only auras during that period does not disqualify the driver.
- A physician may recommend an additional 3-month restriction if, in their professional opinion, the seizure disorder is likely to impair safe vehicle operation for longer than the standard period.
- Providers must also report patients who have experienced a single seizure.
Available Waivers for the Seizure-Free Requirement
Licensed physicians may recommend a waiver of the 3-month seizure-free requirement in specific circumstances outlined in 67 Pa. Code § 83.4(b):
- A strictly nocturnal pattern of seizures or seizures occurring only immediately upon awakening that has been established for at least 2 years.
- A specific prolonged aura with sufficient warning that has been established for at least 2 years.
- The patient was previously seizure-free for 3 months and the subsequent seizure(s) resulted from a prescribed change or removal of medication under a physician’s supervision (waiver applies only after reinstitution of previous medication).
- The patient was previously seizure-free for 3 months and the subsequent seizure(s) occurred during or concurrent with a nonrecurring transient illness, toxic ingestion, or metabolic imbalance.
These waiver options allow medically appropriate flexibility while prioritizing road safety.
Who Must Complete and Submit Form DL-121?
Form DL-121 is intended for healthcare professionals only. Pennsylvania law requires physicians, chiropractors, physician assistants, certified registered nurse practitioners, and other persons authorized to diagnose or treat disorders and disabilities to report qualifying conditions within 10 days.
Reports are mandatory for any patient 15 years of age or older diagnosed with a condition that could impair the ability to safely operate a motor vehicle. Healthcare providers are immune from civil or criminal liability when they report as required by law. Failure to report may expose providers to potential liability if a crash occurs.
Patients and family members do not complete DL-121 themselves. Instead, they should discuss driving concerns with their treating provider, who will determine whether a report is necessary.
How to Access and Submit PennDOT Form DL-121
Access to Form DL-121 and other medical reporting forms requires special login credentials issued by PennDOT. Healthcare professionals who do not yet have credentials can request them through the official Medical Reporting portal on the PennDOT Driver and Vehicle Services website.
Once credentials are obtained, providers can:
- Download the PDF version of DL-121.
- Complete and submit the form electronically in many cases using PennDOT’s secure online process (DocuSign integration is available for certain forms).
- Mail, fax, or email completed forms to the Medical Unit when electronic submission is not used.
Official submission address:
Bureau of Driver Licensing
Driver Qualifications Section
P.O. Box 68682
Harrisburg, PA 17106-8682
Fax: (717) 705-4415
Email: [email protected]
For questions about the form or medical reporting process, contact PennDOT’s Customer Call Center at 717-412-5300 or the Medical Unit at 717-787-9664.
Direct download link: PennDOT Form DL-121 Seizure Reporting Form (PDF).
What Happens After Form DL-121 Is Submitted?
When PennDOT receives a completed DL-121, the Medical Unit reviews the information. Possible outcomes include:
- Temporary recall of driving privileges for the required seizure-free period.
- Addition or removal of license restrictions.
- Request for additional medical documentation or a special driver’s examination.
- Restoration of driving privileges once the physician certifies the patient meets the medical criteria.
- No action if the report supports continued qualification to drive.
All medical reports submitted to PennDOT are confidential and used solely to determine driving qualification. PennDOT does not disclose the source or content of reports to the patient or third parties.
Additional Resources for Drivers and Healthcare Providers
Drivers and families affected by seizure-related reporting can find helpful information on the official PennDOT Medical Reporting Information Center. Healthcare providers should also review the full list of medical reporting forms and the Medical Reporting FAQs available on the same site.
Related official pages include:
- Medical Reporting Forms
- Medical Reporting Frequently Asked Questions
- 67 Pa. Code § 83.4 – Seizure Disorder
Conclusion
The Pennsylvania PennDOT Form DL-121 Seizure Reporting Form plays an essential role in balancing individual driving privileges with public safety. Healthcare providers must use this form to report seizure disorders and single seizures in accordance with state law. Drivers should work closely with their physicians to understand the 3-month seizure-free standard, possible waivers, and the steps needed to restore driving privileges when medically appropriate.
For the most current version of the form and official guidance, always refer to the Pennsylvania Department of Transportation’s official website and download Form DL-121 directly from the trusted source: Download PennDOT Form DL-121.