Medical Certificate For Motor Vehicle Driver (Form 3712) printable pdf download

Medical Certificate for Motor Vehicle Driver

Transport Operations (Passenger Transport) Act 1994, Tow Truck Act 1973

Transport Operation (Road Use Management) Act 1995

The following information is provided to guide you through the process of when you

• If your treating doctor thinks it is necessary, or the AFTD requires it, you may be

have a permanent, or long-term medical condition and a medical assessment is required

required to be assessed by an appropriate specialist before your treating doctor

to determine whether you meet the medical criteria for the class of driver licence you

is able to provide the department with an opinion about whether you meet the

currently hold, or the class of driver licence you are applying for.

medical criteria for a driver licence.

Your treating doctor will undertake your medical assessment in accordance with the

• If your treating doctor has referred you to an optometrist or ophthalmologist,

nationally consistent medical standards set out in the Austroads Assessing fitness to

Part 3 of the Medical Certificate for Motor Vehicle Driver (form F3712) must be

drive for commercial and private vehicle drivers (AFTD) publication.

completed by your treating optometrist or ophthalmologist. If you need to wear

glasses or contact lenses when driving, take these with you to your appointment.

Notifying the Department of Transport and Main Roads (the department)

• Any reports from your specialist, physiotherapist, occupational therapist,

If you hold a Queensland driver licence, or are applying for a Queensland driver

optometrist or ophthalmologist must be given to your treating doctor before they

licence, you have a legal obligation to notify the department as soon as you become

can complete Part 2 of the Medical Certificate for Motor Vehicle Driver (form

aware of any permanent, or long-term medical condition that is likely to adversely

F3712) and provide an opinion regarding your medical fitness to drive.

affect your ability to drive safely.

The department can legally require you to give medical evidence (i.e. a current Medical

If there is a delay in seeing your specialist

Certificate for Motor Vehicle Driver (form F3712) completed by your treating doctor)

If there is a delay before you can see a specialist, talk to your treating doctor about

about whether you meet the medical criteria for the class of driver licence you hold, or

whether you meet the criteria to hold a conditional licence. If so, your doctor may

the class of driver licence you are applying for.

issue you with an interim Medical Certificate for Motor Vehicle Driver (form F3712)

to cover this period on the provision that you have an appointment booked and your

Forms required

medical condition is not likely to lead to an acute incapacity, or loss of concentration

Private and Commercial Vehicle Driver’s Health Assessment (form F3195). This form

before you see the specialist.

has been developed to assist your treating doctor with their medical assessment to

determine whether you meet the medical criteria for a conditional, or unconditional

Your completed Medical Certificate for Motor Vehicle Driver (form F3712)

driver licence. The completed Private and Commercial Vehicle Driver’s Health

You can present your completed Medical Certificate for Motor Vehicle Driver (form

Assessment (form F3195) will be retained by your treating doctor as part of their

F3712) at your nearest TMR customer service centre, or you can send it via:

records. To download a copy of this form please visit

Email:

mcr@tmr.qld.gov.au

Mail:

Department of Transport and Main Roads

Medical Certificate for Motor Vehicle Driver (form F3712). This form has been

Locked Bag 2000

developed so that your treating doctor and/or optometrist, or ophthalmologist may

Red Hill Rockhampton Qld 4701

provide an opinion to the department about whether you meet the medical criteria for a

driver licence and any recommended conditions/restrictions that should be associated

Fax:

4931 1624

to your driver licence. For additional copies of this form please

The department will consider the opinion of your treating doctor and any

visit

recommended conditions/restrictions and make a decision about whether you are

Health professional fees

eligible for the class of driver licence you currently hold, or the class of driver

You are responsible for payment of any fees that are charged by health professionals for

licence that you are applying for.

their services. Such fees are set at the discretion of each individual health professional.

If you do not agree with the decision

Getting your completed Medical Certificate for Motor Vehicle Driver (form F3712)

If you do not agree with the department’s decision you can apply for a

• Make an appointment with your treating doctor to determine if you have a

reconsideration of the decision by completing an Application for Reconsideration of

permanent, or long-term medical condition that is likely to adversely affect your

a Decision of the Chief Executive (form F2981). The Application for Reconsideration

ability to drive safely. When making your appointment, advise the receptionist

of a Decision of the Chief Executive (form F2981) is available from a TMR customer

why you are making the appointment as this kind of medical assessment may take

service centre, or by telephoning 13 23 80*.

longer than a standard consultation.

Alternatively, you can apply to the Queensland Civil and Administrative Tribunal

• To assist your treating doctor with your medical assessment, complete the

(QCAT) for a review of the decision. For information about the QCAT process,

health questionnaire on page 1 of the Private and Commercial Vehicle Driver’s

please call 1300 753 228 or visit

Health Assessment (form F3195) prior to your appointment and give it to your

treating doctor. Your treating doctor will complete page 2 as part of their medical

Indemnity for health professionals

assessment and will generally retain the completed form for their records.

The Transport Operations (Road Use Management) Act 1995 provides indemnity

• You will also need to complete Part 1 of the Medical Certificate for Motor Vehicle

against liability, both civilly or under an administrative process, for health

Driver (form F3712) prior to your appointment and give it to your treating doctor at

professionals who give information in good faith to the department about a person’s

the commencement of your medical assessment.

medical fitness to hold, or to continue to hold a Queensland driver licence.

• If the medical assessment has been requested for a particular reason e.g. you have

For more information

been issued a show cause notice on medical grounds by the department, you need

For more information about medical conditions and driving, please visit

to advise your treating doctor of this reason. If you need to wear glasses or contact

or call 13 23 80*.

lenses when driving, make sure you take these with you to your appointment.

• If you drive, or intend to drive a vehicle for commercial reasons (e.g. a class

*Check with your service provider for call costs.

MR, HR, HC or MC vehicle, drive a bus or a personalised transport service etc.),

you must tell your treating doctor so that you are assessed correctly under the

Page 1 of 4

TRB Forms Area

F3712

V01 Apr 2017

commercial standards in the AFTD.

Privacy Statement: The Department of Transport and Main Roads (the

department) collects this information under the provisions of the Acts nominated

on this form so that you may confirm your medical fitness to drive a motor vehicle

safely. The department may disclose this information to interstate authorities that

issue driver licences, pilot or escort vehicle driver accreditations, driver or rider

training accreditations, traffic controller accreditations, dangerous goods vehicle

licences, tow truck licences and driver authorisations, and the Queensland Police

Service (QPS). Your information will not be disclosed to any other third parties

without your consent, unless required or authorised by law.

Medical Certificate For Motor Vehicle Driver (Form 3712)

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