PennDOT Form DL-129: Loss of Consciousness Guide – The Pennsylvania Department of Transportation (PennDOT) requires healthcare providers to report certain medical conditions that may affect a driver’s ability to operate a vehicle safely. One of the key reporting tools is Form DL-129, officially titled the Loss of Consciousness And/Or Awareness Form. This form helps PennDOT evaluate whether a driver’s privilege should be restricted, suspended, or recalled under Pennsylvania’s physical and mental criteria for licensing.
What Is PennDOT Form DL-129?
Form DL-129 is a specialized medical reporting form used exclusively by licensed healthcare professionals in Pennsylvania. It documents episodes of loss of consciousness or loss of awareness that may impair a person’s ability to drive safely. The form is part of PennDOT’s broader medical reporting system under Chapter 83 of Title 67 of the Pennsylvania Code (Physical and Mental Criteria, Including Vision Standards Relating to the Licensing of Drivers).
Healthcare providers complete DL-129 to report patients who experience periodic episodes of loss of consciousness or loss of attention/awareness of unknown etiology (or not otherwise categorized). The information allows PennDOT’s Medical Unit to determine whether the individual meets the standards for holding a driver’s license.
Official access to the protected form is restricted to registered healthcare professionals. A public version of the form is available for reference and download.
Download the official PennDOT Form DL-129 (PDF):
https://www.pa.gov/content/dam/copapwp-pagov/en/penndot/documents/public/dvspubsforms/bdl/bdl-medical-protected/dl-129.pdf
Legal Basis: Pennsylvania Code Requirements
The use of Form DL-129 is grounded in 67 Pa. Code § 83.5, which sets physical and medical standards for drivers (other than school bus drivers).
- § 83.5(a)(3) – A person who has periodic episodes of loss of consciousness of unknown etiology or not otherwise categorized will not be qualified to drive unless the person has been free from episode for the year immediately preceding.
- § 83.5(b)(6) – A provider may recommend license action if the individual has periodic episodes of loss of attention or awareness of unknown etiology or not otherwise categorized, unless the person has been free from episode for the year immediately preceding, as reported by a licensed physician.
These standards are established under the authority of the Pennsylvania Vehicle Code (75 Pa.C.S. §§ 1517 and 1518) and the Medical Advisory Board. Healthcare providers have a duty to report conditions that may affect safe driving.
Related conditions (such as seizures, cardiovascular disease causing syncope, or diabetes-related episodes) are reported on other specific forms (DL-121, DL-120, DL-122, etc.). Form DL-129 is reserved for loss of consciousness or awareness that does not fall into those more specific categories.
Who Must Complete Form DL-129?
Only licensed healthcare providers may complete and submit Form DL-129. This includes:
- Licensed physicians (M.D. or D.O.)
- Certified Registered Nurse Practitioners (CRNPs)
- Physician assistants
- Other providers authorized under 75 Pa.C.S. § 1518 and 67 Pa. Code Chapter 83
The form is not intended for self-reporting by drivers. Drivers who experience loss of consciousness or awareness should discuss the matter with their healthcare provider, who will determine whether reporting to PennDOT is required.
To access the official online/protected version of medical reporting forms, healthcare professionals must register for credentials through PennDOT’s Driver and Vehicle Services medical reporting portal.
When Is Form DL-129 Required?
Healthcare providers should use DL-129 when a patient has experienced:
- Periodic episodes of loss of consciousness of unknown cause or not otherwise categorized; or
- Periodic episodes of loss of attention or awareness that would make the person unsafe to drive, of unknown etiology or not otherwise categorized.
Key timing rule: The individual generally remains qualified (or may regain qualification) if free from such episodes for the full year immediately preceding the report. Providers document the history of episodes, diagnostic findings, treatment, and their professional opinion regarding driving safety.
Providers are also expected to report under the broader duty in 67 Pa. Code § 83.6 when they believe a person is not qualified to drive because of a condition covered by Chapter 83.
Information Typically Requested on Form DL-129
While the exact fields may be updated periodically, Form DL-129 generally collects:
- Patient identification (driver’s license number, name, address, date of birth, contact information)
- Healthcare provider information (name, specialty, license number, address)
- Length of time the provider has treated the patient
- Diagnosed diseases or conditions
- History of multiple episodes of loss of consciousness (including dates of the most recent episodes)
- History of multiple episodes of loss of awareness that would make the patient unsafe to drive (including dates)
- Diagnostic tests performed
- Current treatment and prognosis
- Provider’s recommendation regarding the patient’s ability to drive safely
- Provider signature and date
Accurate and complete information is essential for timely processing by PennDOT.
How to Submit Form DL-129
PennDOT encourages electronic submission for registered healthcare providers. The protected version of the form can be completed and signed digitally through PennDOT’s DocuSign process. Once finished, the completed form is automatically transmitted to PennDOT for processing.
Providers who do not yet have credentials can request them via the official PennDOT medical reporting contact form available on the Driver and Vehicle Services website.
For questions about the form or medical reporting process, contact PennDOT’s Driver and Vehicle Services Customer Call Center at 717-412-5300. Reference “Driver Licensing Form” for content questions or “DocuSign DVS” for technical issues with electronic submission.
Official medical reporting resources and forms are maintained on the Commonwealth’s Driver and Vehicle Services site:
https://www.pa.gov/agencies/dmv/resources/medical-reporting/medical-reporting-forms
What Happens After Submission?
After receiving Form DL-129, PennDOT’s Medical Unit reviews the information. Possible outcomes include:
- No action if the patient has been episode-free for the required period and is otherwise qualified
- Request for additional medical information or examination
- Recall, suspension, or restriction of the driving privilege
- Periodic follow-up reporting requirements
Drivers whose privileges are affected will receive official notice from PennDOT explaining the action and any restoration requirements. Drivers have the right to request a hearing under applicable administrative procedures.
Related Medical Reporting Forms
PennDOT maintains separate forms for other medical conditions that affect driving. Common related forms include:
- DL-120 – Cardiovascular conditions
- DL-121 – Seizure disorder / epilepsy
- DL-122 – Diabetes mellitus
- DL-124 – Neurological conditions
- DL-126 – Orthopedic conditions
- DL-131 – Cognitive impairment
- DL-104 – Psychiatric conditions
Using the correct form helps ensure accurate and efficient processing.
Important Notes for Drivers and Providers in Pennsylvania
- Medical reporting protects public safety while balancing individual driving privileges.
- Providers should base reports on current clinical findings and the standards in 67 Pa. Code Chapter 83.
- Drivers concerned about a medical condition should consult their healthcare provider rather than attempting self-reporting on DL-129.
- School bus drivers are subject to additional standards under Chapter 71 and may use different forms.
- Always verify the most current form and instructions on the official Pennsylvania government website, as procedures can be updated.
Download PennDOT Form DL-129
Obtain the official Loss of Consciousness And/Or Awareness Form directly from the Commonwealth of Pennsylvania:
For the most current medical reporting information, visit the official Medical Reporting Forms page:
PennDOT Medical Reporting Forms
For general driver licensing questions, contact PennDOT Driver and Vehicle Services at 717-412-5300 or visit www.pa.gov/agencies/dmv.