PennDOT DL-122B DS: School Bus Diabetic Waiver Form – School bus drivers in Pennsylvania who manage diabetes with insulin or other hypoglycemic medications may qualify for a medical waiver under specific conditions. When certain blood sugar control thresholds are exceeded, PennDOT requires more frequent monitoring. The official document for this purpose is PennDOT Form DL-122B DS, known as the School Bus Driver Diabetic Waiver (3 Month Follow Up Form). This form supports electronic submission and is designed exclusively for use by healthcare professionals.
This guide explains what the form is, who needs it, the regulatory background, how to complete and submit it electronically, and where to access the official document. All information is drawn from current Pennsylvania Department of Transportation (PennDOT) resources and state regulations.
What Is PennDOT Form DL-122B DS?
Form DL-122B DS is the electronic-submission version of the School Bus Driver Diabetic Waiver (3 Month Follow-Up Form). It is used when a school bus driver who holds a diabetes waiver has recorded two consecutive Hemoglobin A1C (HbA1C) test results greater than 8%. In these cases, Pennsylvania regulations require additional diabetic examinations every three months.
The form allows the treating healthcare provider to review the driver’s self-monitoring blood glucose logs, report the highest and lowest blood glucose levels for the three-month period, and certify that the observed levels are not suggestive of hypoglycemic or hyperglycemic driving impairment.
The “DS” suffix indicates that the form is available for electronic (digital signature) submission through PennDOT’s secure process. This helps speed processing compared with paper submissions.
Official source: PennDOT Medical Reporting Forms.
Who Needs to Complete Form DL-122B DS?
This form applies only to Pennsylvania school bus drivers who:
- Require insulin or other hypoglycemic medication to manage diabetes mellitus,
- Have already been granted a diabetes waiver under 67 Pa. Code § 71.3(b)(4), and
- Have had two consecutive HbA1C results greater than 8%.
Once two consecutive HbA1C results of 8% or lower are achieved, the driver may discontinue the three-month reporting requirement and return to the standard six-month examination schedule.
Important: The form is restricted to healthcare professionals. A password-protected login is required. Drivers themselves do not complete or submit the form.
Regulatory Requirements for School Bus Drivers with Diabetes
Pennsylvania school bus driver medical standards are set out in Title 67 of the Pennsylvania Code, Chapter 71. Key provisions related to diabetes include:
- A person with diabetes requiring insulin or other hypoglycemic medication is not automatically qualified to drive a school bus.
- A waiver may be granted if the healthcare provider verifies no severe hypoglycemic reaction or symptomatic hyperglycemia, and no insulin reaction resulting in loss of consciousness, attention, awareness, or need for assistance from another person, for the preceding 12 months.
- The driver must undergo a diabetic examination every six months and submit results plus an HbA1C test on a form provided by the Department.
- If two consecutive HbA1C results exceed 8%, additional examinations are required every three months (this is when Form DL-122B is used).
- An annual dilated eye examination is required.
- Drivers must self-monitor blood glucose one hour before driving and at least every four hours while on duty, keep logs, carry rapidly absorbable glucose, and meet other management requirements.
These rules prioritize public safety while allowing qualified drivers who maintain good control to continue operating school buses. Full regulation text is available at 67 Pa. Code § 71.3.
How to Access and Submit Form DL-122B DS Electronically?
PennDOT has transitioned many medical forms, including DL-122B, to electronic submission. The process uses a secure digital signature platform.
- Healthcare professionals must first obtain login credentials if they do not already have them. Credentials can be requested through the official PennDOT medical email form available on the Medical Reporting Forms page.
- Once credentials are active, access the electronic form through the protected link provided by PennDOT.
- Enter the full name and email address of the signer (and any additional signers if required).
- Complete all required fields on the form, including review of blood glucose logs and certification statements.
- Apply the digital signature.
- Click “Finish.” The completed form is automatically emailed to PennDOT for processing.
For questions about the form content, contact the PennDOT Driver and Vehicle Services Customer Call Center at 717-412-5300 and reference “Driver Licensing Form.” For technical issues with the digital signature process, reference “DocuSign DVS.”
Official instructions appear on the form landing page: PennDOT DL-122B DS Information.
Download the Official Form DL-122B DS
You can download the official Pennsylvania PennDOT Form DL-122B DS – School Bus Driver Diabetic Waiver (3 Month Follow Up Form) for electronic submission directly from the Commonwealth of Pennsylvania website:
Download PennDOT Form DL-122B DS (PDF)
Note that the downloadable file primarily provides access instructions. The actual fillable electronic form is completed online after authentication.
Related Forms and Additional Resources
School bus drivers with diabetes may also encounter these related documents:
- DL-122A – Primary School Bus Driver Diabetic Waiver form used for the standard six-month examinations.
- DL-122 – General diabetic form for non-school-bus drivers.
- DL-704 – School Bus Driver’s Physical Examination form.
All medical reporting forms and credential requests are centralized on the official page: PennDOT Medical Reporting Forms.
For general school bus driver licensing information, visit the official PennDOT page on becoming a school bus driver: Become a School Bus Driver.
Why Compliance Matters?
Strict adherence to the three-month follow-up requirements protects both the driver and the public. Failure to submit required medical documentation can result in the rescission of a diabetes waiver and loss of the school bus endorsement. Healthcare providers who determine that a previously waived driver is no longer in compliance must report those findings promptly to PennDOT.
By using the electronic DL-122B DS process, providers help ensure timely review and reduce delays that could affect a driver’s ability to work.
Contact PennDOT for Assistance
PennDOT Driver and Vehicle Services Customer Call Center: 717-412-5300
Hours: Monday through Friday (except holidays), 8:00 a.m. – 5:00 p.m. ET
TTY: Dial 711
Always verify the most current requirements directly with PennDOT, as regulations and form versions can be updated.