DS-6 Form – The DS-6 Form, officially known as the Physician’s Medical Reporting Form, is a critical New York State Department of Motor Vehicles (NY DMV) document used to report drivers whose physical or mental conditions may impair their ability to operate a motor vehicle safely. If you are a licensed physician, physician assistant, or nurse practitioner in New York, or simply researching medical reporting requirements for road safety, this guide covers everything you need to know about the DS-6 form, including its purpose, how to complete it, and the official download link.
What Is the DS-6 Form: Physician’s Medical Reporting Form?
The DS-6 is the Physician’s Reporting Form issued by the New York DMV. It allows qualified medical professionals to notify the DMV’s Medical Review Unit when a patient’s mental or physical condition could affect safe driving. The form is voluntary but plays a vital role in public safety by helping the DMV identify at-risk drivers.
Revised as of June 2023, the current DS-6 form is a one-page document that collects driver identification, a detailed description of the medical condition, and the reporting professional’s certification. It is not a general medical statement but a specific tool for driver fitness reporting.
Purpose of the NY DMV DS-6 Form
The primary purpose of the DS-6 form is to trigger a medical review of a New York-licensed driver. When a physician submits the form indicating that a condition “may affect” or “prevents” safe vehicle operation, the DMV may suspend the driver’s license until a physician certifies that the condition is treated or controlled.
This process protects both the driver and other road users. The DMV can require periodic recertification and may request additional specialist input (such as from a cardiologist or neurologist) based on the information provided.
Who Can Complete the DS-6 Physician’s Reporting Form?
Only licensed physicians, physician assistants, or nurse practitioners may complete and sign the DS-6 form. The form explicitly states it must be filled out by a qualified medical professional who has treated or evaluated the patient.
Important note on HIPAA and consent: Reporting generally requires the patient’s written consent because the form discloses protected health information. There is no legal duty for physicians to report in New York unless compelled by court order or other specific exceptions. Always review privacy guidelines before submitting.
When Should a Physician Submit the DS-6 Form?
Submit the DS-6 form when you determine that a patient’s condition—such as seizures, vision impairment, cognitive decline, or medication side effects—may interfere with safe driving. The DMV encourages prompt reporting “in the interest of the health and safety of the driver and the safety of all highway users.”
It is especially relevant for older drivers or those with progressive conditions. The form is not for one-time emergencies but for ongoing or newly identified impairments that could affect long-term driving ability.
How to Fill Out the DS-6 Form: Step-by-Step Instructions?
Filling out the DS-6 is straightforward. Follow these steps exactly as outlined in the official instructions:
- Part 1 – Driver Identification: Provide the patient’s full name, address, date of birth, and New York driver license number (all required fields marked with *).
- Part 2 – Description of the Driver’s Condition:
- Indicate whether you have treated the patient.
- Enter the date of the last examination.
- Describe the condition and any current treatment.
- Note if the patient is on medication (include type and dosage).
- Check one of two boxes: (a) the condition may affect safe operation (DMV evaluation recommended), or (b) the condition prevents safe operation (driving privileges should be suspended).
- Add further details or attach a letterhead statement.
- Part 3 – Physician/PA/NP Certification: Enter your full name, license number, specialty, contact information, mailing address, signature, and date. Attach your letterhead or a blank prescription for verification.
Mail the completed original form (do not fax or email).
Official DS-6 Form PDF Download
Direct download link: DS-6 Physician’s Medical Reporting Form (PDF)
This is the most current version hosted directly on the official NY DMV website. Always download from dmv.ny.gov to ensure you have the latest form.
How to Submit the DS-6 Form to NY DMV?
There is no online submission option. Mail the completed and signed DS-6 form to:
Medical Review Unit
New York State Department of Motor Vehicles
6 Empire State Plaza, Room 337
Albany, NY 12228
For assistance, call the Medical Review Unit at (518) 474-0774 (option #2 then #3).
What Happens After Submitting the DS-6 Form?
Once received, the DMV’s Medical Review Unit reviews the report. Possible outcomes include:
- Request for additional medical documentation or specialist evaluation.
- Temporary license suspension until the driver provides clearance from a physician.
- Periodic recertification requirements.
The driver is notified and given an opportunity to respond. Failure to provide required medical clearance can result in continued suspension or revocation.
Frequently Asked Questions About the DS-6 Form
Is the DS-6 form mandatory?
No. Physicians are not legally required to report, but voluntary reporting helps maintain highway safety.
Can patients submit the DS-6 themselves?
No. Only licensed medical professionals may complete and sign it. Patients or concerned individuals use Form DS-7 instead.
Is the reporter’s identity protected?
Your identity is not protected under the Freedom of Information Law, but the DMV handles reports professionally.
Are there other related medical forms?
Yes. For specific heart or vision conditions, physicians may also use MV-80U.1 or MV-80L forms as part of the broader Medical Review Program.
For the most up-to-date information, always refer to the official NY DMV pages on reporting a medical condition and the Medical Review Program.
Stay safe on New York roads — the DS-6 form is a simple but powerful tool that medical professionals can use to protect everyone behind the wheel. Download your copy today and keep the official submission address handy.