Florida HSMV Form 72480 – Alcohol & Drug Usage Guide – The Florida Department of Highway Safety and Motor Vehicles (FLHSMV) requires specific medical documentation when a driver’s ability to operate a vehicle safely may be affected by alcohol or drug use. One of the key documents in this process is HSMV Form 72480, officially titled the Alcohol and Drug Usage Form.
This form plays a critical role in the state’s Medical Review Program. It helps the Department determine whether an applicant or licensed driver with a history of substance use can safely drive. Below is a clear, up-to-date guide for Florida residents on what the form is, when it is needed, how to complete it, and how to submit it correctly.
What Is Florida HSMV Form 72480?
HSMV 72480 is the official Alcohol and Drug Usage Form used by the Florida Department of Highway Safety and Motor Vehicles. The current version is effective as of July 2018 and is incorporated by reference in Florida Administrative Code Rule 15A-5.012 (Drug Addiction and Alcoholism).
The form must be completed by a physician or treatment provider. It collects detailed information about an individual’s history of alcohol and/or drug use, any treatment received, current aftercare participation, length of sobriety, and the provider’s professional opinion on whether the person is capable of safely operating a motor vehicle.
Official download link: Download Florida HSMV Form 72480 (PDF)
When Is Form 72480 Required?
According to Florida Administrative Code Rule 15A-5.012, an applicant or licensed driver with a drug, alcohol, or substance abuse disorder that makes them incapable of driving safely will not be issued a license or will have their license revoked.
However, the same rule allows approval for licensure after the individual has received counseling and/or treatment from a substance abuse specialist or treatment center and has met all applicable requirements under Chapters 316 and 322 of the Florida Statutes. As part of that process, the person must submit a completed HSMV 72480 form from a physician or treatment source showing compliance with treatment and the ability to operate a motor vehicle safely.
Common situations that may trigger a request for this form include:
- Medical review initiated after a report of substance-related concerns
- Application for a driver license following treatment for alcohol or drug issues
- Reinstatement processes involving medical conditions related to substance use
- Follow-up required by the Medical Advisory Board or Medical Review Program
The form is part of FLHSMV’s broader Medical Review process, which evaluates whether a medical condition interferes with safe driving.
Who Must Complete the Form?
The form clearly states: “Please have this form completed by your physician or treatment provider.” The driver or applicant cannot complete the clinical portions themselves. The licensed physician or qualified treatment provider must answer all questions and sign the document.
Required provider information includes:
- Signature
- Printed name
- Position / Medical License Number
- Address
- Telephone number
- Date
What Information Does Form 72480 Request?
The form is relatively short but requires specific clinical details. Sections include:
- Brief history of the individual’s alcohol and/or drug usage.
- Treatment program participation – Yes/No, plus location, length of treatment, and admission/discharge dates if applicable.
- Current aftercare participation and frequency of attendance.
- Length of time the provider has known the individual and frequency of contact.
- Length of time the individual has been alcohol and/or drug free (to the best of the provider’s knowledge).
- Professional opinion on whether the individual is capable of operating a motor vehicle safely (Yes/No), with space for comments.
The form also collects basic identifying information for the client/patient: full name, date of birth, driver license number, and telephone number.
How to Submit the Completed Form?
Once the physician or treatment provider has fully completed and signed the form, it must be sent directly to the Medical Review Program. Do not submit it to a local driver license office or tax collector.
Mailing Address:
Bureau of Motorist Compliance
Medical Review Program
Neil Kirkman Building, MS 86
Tallahassee, Florida 32399-0500
Fax: (850) 617-3944
Telephone: (850) 617-3814
According to FLHSMV guidance, medical forms may be faxed to the Medical Review Section. Drivers who need an extension of time to submit required medical documentation should contact the Medical Review Section at (850) 617-3814, as extensions are granted on a case-by-case basis.
The Medical Review Process in Florida
When FLHSMV receives a report or information suggesting a possible medical issue affecting driving safety, the Department may open a medical review. The driver is typically notified in writing and given a deadline (often 45 days) to submit the requested medical documentation, which may include Form 72480.
Completed medical information is reviewed by the Medical Advisory Board. Florida law requires FLHSMV to render a decision within 90 days after receiving all requested medical information. The driver is then notified in writing of the outcome.
Possible results include approval to drive (sometimes with conditions such as follow-up reports), a requirement for additional testing or evaluation, or denial/revocation of the driving privilege if the condition is determined to pose a risk to public safety.
Drivers may submit additional or updated medical information, or a Certified Driver Evaluation by a Certified Driver Rehabilitation Specialist, for reconsideration at any time.
Official Sources and Related Resources
For the most accurate and current information, always refer to official FLHSMV resources:
- Official HSMV 72480 PDF
- FLHSMV Forms Page
- FLHSMV Medical Review Overview
- The Medical Review Process
- Medical Review FAQs
- Medical Review Contact Information
- Florida Administrative Code Rule 15A-5.012 – Drug Addiction and Alcoholism
Important Tips for Florida Drivers
- Only a qualified physician or treatment provider should complete the clinical sections of Form 72480.
- Provide the form to your provider promptly and confirm it has been fully completed and signed.
- Keep a personal copy of the completed form for your records.
- Submit the form directly to the Medical Review Program in Tallahassee by mail or fax.
- Respond to any FLHSMV correspondence within the stated deadlines to avoid further action on your driving privilege.
- If you have questions about your specific case, contact the Medical Review Section at (850) 617-3814 rather than relying solely on third-party information.
Conclusion
Florida HSMV Form 72480 is a specialized medical form used to evaluate alcohol and drug usage history in the context of driver licensing and medical review. When properly completed by a physician or treatment provider and submitted to the Bureau of Motorist Compliance – Medical Review Program, it helps the Department make informed decisions that balance individual mobility with public safety on Florida roads.
For the official form and the most current guidance, always download Form 72480 directly from the Florida Department of Highway Safety and Motor Vehicles website and follow the instructions provided in any official correspondence you receive.