Fillable Nsw Medical Assessment Form (Page 4 of 7) in pdf

Medical Assessment Form Public Passenger Vehicle Driver continued

Important information for Medical Practitioner

The medical examination must be conducted in accordance with the commercial medical standards described in the

“Assessing Fitness to Drive, Commercial and Private Vehicle Drivers (2012)”. This publication is available from the

web on It details the examination process, but the forms you must use are those provided by

Roads and Maritime and/or TfNSW, not those given as examples in the appendix to the standards. The criteria to be

used are those detailed in the right hand column, marked “Commercial Standards”.

Upon completion of the examination complete Parts E and F and sign Part G of the form and give to the patient to

return to Roads and Maritime and/or TfNSW.

You should retain a copy of this form for the patient's medical record together with detailed examination notes.

Information not relevant to the patient's fitness to drive should not be forwarded to Roads and Maritime and/or TfNSW.

If you have doubts about the patient's fitness to drive, please give reasons in the comments section on the form, and

arrange referral to a specialist for an opinion (see below).

If you recommend consideration for a conditional Authority, you will need to make a referral to an appropriate

specialist(s) and hand the Medical Specialist Referral form to the applicant/driver to take to the specialist(s) for

completion.

You may also recommend a practical driving test to assess fitness to drive. Please indicate this in the final section of

the form, the Medical Assessment Certificate.

If you have any doubts about the information required, or wish to discuss the case, please contact Roads and

Maritime and/or TfNSW.

Driving Assessment

There are two types of Driving Assessments:

A Practical Driving Test can be conducted by an Accredited Driving Assessor. This type of assessment looks at a

driver's ability to safely handle the type of vehicle in question, e.g. taxi, bus, motorcycle etc. Note; any cost involved is

to be met by the driver.

More complex assessments may be requested with a Driver Rehabilitation Unit, or by an accredited occupational

therapist, if warranted. Normally this would only be required in cases where the driver has a disability which could

compromise safe and effective control of the vehicle. Additional medical specialist advice may also be required, e.g.

from an occupational or rehabilitation physician, in such cases. Your local office listed on page 3 can assist with

locating the closest suitable provider for these assessments.

The main aim of assessment by an occupational therapist or Driver Rehabilitation Unit is to assist people with

impairments to resume or continue driving. There are two components of the assessment. The first part of the

assessment aims to evaluate the person's difficulties. This involves an interview, vision screen, cognitive function test,

assessment of physical strength, motor skills, reaction time, road law and road craft. The need for specialist

equipment of vehicle modifications is considered at this time.

The on-road assessment takes a standard approach but can be designed to meet individual needs. It is conducted in

a dual controlled vehicle, accompanied by a driving instructor and where necessary set up with special requirements

or modifications to meet the needs of the driver. The assessment is structured to assess the impact of injury, illness or

the aging process on driving skills such as judgement, decision-making skills, observation and vehicle handling.

Conditions and Restrictions

If appropriate, the medical practitioner may recommend conditions which may be imposed upon the driver authority

and that go to driver competency or safety and allow the driver to continue to drive (e.g. corrective lenses, no night

driving, additional mirrors).

If the medical practitioner makes a recommendation to impose conditions, reasons must be provided.

If the medical practitioner is of the opinion that vehicle modifications are necessary (e.g. hand controls, left foot

accelerator), or a prosthesis is necessary to drive safely, or that a local area driving restriction is appropriate, the

driver will need to demonstrate the ability to drive safely with these restrictions. In these cases a driver assessment is

necessary.

continued page 5

Catalogue No. 45071751 Form No. 1689 (03/2016) ABN 76 236 371 088

Page 4 of 7

Nsw Medical Assessment Form Page 4

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