PennDOT DL-123 General Medical Form

PennDOT DL-123 General Medical Form | Official PA Guide – The Pennsylvania Department of Transportation (PennDOT) uses Form DL-123, known as the General Medical Form, as a key tool in its medical reporting program. This form helps determine whether a person is medically qualified to safely operate a motor vehicle on Pennsylvania roads. Healthcare professionals complete and submit it when a patient age 15 or older has a condition that could impair driving ability.

This SEO-optimized guide covers the purpose of the DL-123 form, who uses it, how to access and submit it, related medical regulations, and official resources. All information is drawn from current PennDOT and Commonwealth of Pennsylvania sources.

What Is the PennDOT Form DL-123 General Medical Form?

Form DL-123 is the official General Medical Form issued by PennDOT’s Bureau of Driver Licensing. It serves as a comprehensive medical evaluation document used primarily by licensed healthcare providers. The form collects detailed information about a patient’s medical history, current conditions, medications, physical and mental status, vision, and hearing to assess fitness to drive.

Unlike condition-specific forms (such as those for diabetes, seizures, or cardiovascular issues), the DL-123 is the general-purpose reporting form. Healthcare professionals use it when a broader medical assessment is needed or when no specialized form applies.

Access to the official form is restricted. PennDOT states that the form is for healthcare professionals only and requires a password or medical reporting login credentials. Providers who do not yet have credentials must register through PennDOT’s designated process.

Official download link (PDF): Download PennDOT Form DL-123 – General Medical Form

Purpose of the DL-123 Form in Pennsylvania Medical Reporting

Under Pennsylvania law (Section 1518 of the Vehicle Code), physicians, physician assistants, certified registered nurse practitioners, chiropractors, and other authorized healthcare personnel must report patients 15 years of age or older who have been diagnosed with a condition that could impair the ability to safely operate a motor vehicle. Reports must generally be made within 10 days of diagnosis.

The DL-123 form supports this legal requirement by providing structured medical information that PennDOT’s Medical Unit uses to evaluate licensing decisions. The goal is public safety: identifying drivers whose medical conditions may increase the risk of crashes while also protecting the driving privileges of individuals who remain safe to drive.

Conditions that commonly trigger medical reporting include (but are not limited to) neurological disorders, cardiovascular disease, diabetes with recent severe episodes, cognitive impairment, psychiatric conditions that affect attention or judgment, seizure disorders, and significant orthopedic or visual impairments. Temporary conditions expected to last less than 90 days generally do not require reporting.

Who Completes and Submits the DL-123 Form?

Only qualified healthcare professionals complete Form DL-123. The form is not intended for patients or drivers to fill out themselves. Providers evaluate the patient’s medical history, perform or review relevant examinations, and document their professional assessment of the patient’s ability to drive safely.

Key points for healthcare providers:

Credentials are required to access the protected medical forms, including DL-123.
Providers may request login credentials through PennDOT’s official medical reporting registration process.
The form can be completed and submitted electronically via DocuSign for faster processing. After filling required fields and adding signatures, the completed form is emailed directly to PennDOT.
Multiple signers can be included when necessary.

For technical issues with the electronic process, contact PennDOT’s Driver and Vehicle Services Customer Call Center at 717-412-5300 and reference “DocuSign DVS.” For questions about the form content, reference “Driver Licensing Form.”

How to Access and Submit the Official DL-123 Form?

Because the form is password-protected, the most reliable method is through PennDOT’s medical reporting portal after obtaining credentials. Healthcare professionals can also use the electronic DocuSign pathway described on the official form page.

Steps for electronic submission typically include:

Obtain or confirm medical reporting login credentials.
Access the DL-123 form link provided by PennDOT.
Enter full name and email address (and any additional signer details if required).
Complete all required fields on the form.
Add the electronic signature(s).
Select “Finish” so the completed form is transmitted to PennDOT for processing.

Paper versions may still be accepted in some cases, but electronic submission is preferred for prompt handling. Completed reports are sent to the Bureau of Driver Licensing, Medical Unit.

Direct download: PennDOT DL-123 General Medical Form PDF

Related PennDOT Medical Reporting Forms and Regulations

PennDOT maintains a suite of condition-specific forms under Chapter 83 of the Pennsylvania Code (Medical Regulations for Drivers other than School Bus Drivers) and Chapter 71 for school bus drivers. Examples include:

DL-120 – Cardiovascular
DL-121 – Seizure Disorder/Epilepsy
DL-122 – Diabetes Mellitus
DL-124 – Neurological
DL-126 – Orthopedic
DL-129 – Loss of Consciousness or Awareness
DL-131 – Cognitive Impairment
DL-104 – Psychiatric

The General Medical Form (DL-123) is used when a more comprehensive or non-specific evaluation is appropriate. Providers are encouraged to use the most relevant condition-specific form when possible, as it supplies PennDOT with targeted clinical details.

Full details on medical criteria, reporting requirements, and the review process are available on the official PennDOT Medical Reporting pages.

What Happens After a Medical Report Is Submitted?

Once PennDOT receives a completed medical report (including a DL-123), the Medical Unit reviews the information. Possible outcomes include:

No action – the driver remains fully qualified.
Request for additional information or a follow-up examination.
Imposition of restrictions (for example, daylight-only driving or adaptive equipment).
Recall or suspension of driving privileges if the medical evidence shows the individual cannot safely operate a vehicle.

Drivers have the right to due process, including the opportunity to provide additional medical evidence and, in many cases, a hearing. Medical reports submitted to PennDOT are confidential and used solely for licensing determinations.

Official Resources and Contact Information

For the most current information, always refer to official Commonwealth sources:

Contact the Medical Unit:
Phone: 717-787-9664
Email: [email protected]
Mail: Bureau of Driver Licensing, P.O. Box 68682, Harrisburg, PA 17106-8682
Hours: Monday–Friday, 8:00 a.m. – 4:15 p.m.

Customer Call Center (general form questions): 717-412-5300

Download the Official PennDOT Form DL-123

Healthcare professionals can obtain the current version of the General Medical Form here:

Download Pennsylvania PennDOT Form DL-123 – General Medical Form (PDF)

Remember that password protection and provider credentials apply. Always verify you are using the latest version directly from pa.gov or the official PennDOT medical reporting system.

Conclusion

The Pennsylvania PennDOT Form DL-123 General Medical Form plays an essential role in balancing individual driving privileges with public safety on the Commonwealth’s roadways. Healthcare providers who accurately and promptly complete this form help PennDOT make informed licensing decisions based on current medical evidence.

Drivers and families affected by a medical report should review the official Medical Reporting resources and contact the Medical Unit with questions. For providers, obtaining credentials and using the electronic submission process ensures the fastest and most reliable handling of reports.