Medical Card Form printable pdf download

Medical Card Form

State of New Hampshire

Department of Safety

Division of Motor Vehicles

23 Hazen Drive, Concord, NH 03305

(603) 227-4000

John J. Barthelmes

Richard C. Bailey, Jr.

Commissioner of Safety

Director of Motor Vehicles

Dear CDL Holder,

Our records indicate that you hold a New Hampshire commercial drivers license. Due

to new federal regulations by the U.S. Department of Transportation, your CDL is being

impacted.

The Federal Motor Carrier Administration now requires that all CDL holders or those

applying for a CDL must meet federal physical requirements and provide their medical

card to the Division of Motor Vehicles. All state driver licensing agencies are required

to report and track medical cards.

If your CDL is up for renewal this year, please renew as you normally would and bring

your medical card with you. If your license is not up for renewal this year, please use

one of the following three (3) methods to supply the DMV with a copy of your medical

card. Please keep in mind, all CDL holders will need to comply on or before January

2014 or risk losing CDL privileges.

1. In person, you can go into any of our substations and fill out the form (DSMV

312), present the medical card and we can scan them into our system.

2. Mail in, please answer the questions on the back of this page and send in a

photo copy of your license and medical card (we must have all 3).

NH-DMV

DRIVER LICENSING BUREAU

23 HAZEN DRIVE

CONCORD, NH

03305

3. E-mail the new form filled out and a scanned copy of the DRIVER LICENSE

and MEDICAL CARD in PDF form (we must have all 3).

NHCDLMEDCARDS@dos.nh.gov

Medical Card Form