Report a medically unfit driver: healthcare practitioners

In Ontario, certain healthcare practitioners are required by law to report patients who may be medically unfit to drive. Learn more about the medical reporting process.

The law

Starting in July 2018, medical reporting requirements for healthcare practitioners have changed.

Under section 203 of the Highway Traffic Act, mandatory reporting requirements for high risk medical conditions, vision conditions and functional impairments that make it dangerous for a person to drive apply to:

  • Physicians
  • Optometrists
  • Nurse Practitioners

Also starting in July 2018, physicians, optometrists, nurse practitioners and occupational therapists will have the discretionary authority to report conditions that, in the opinion of the healthcare practitioner, make it dangerous for a person to drive.

Ontario Regulation 340/94 describes those high risk conditions/impairments that are mandatory for a physician, optometrist or nurse practitioner to report. When a report of a mandatory condition is made it will result in a licence suspension.

The regulation provides six categories of medical conditions/impairments. For the sake of convenience and ease of completion the reporting form provides a drop down list of the most frequently reported conditions under each category that make it unsafe to drive.

Note: Optometrists are only required to report with respect to visual impairments. For more information on optometrist’s reporting requirements, see Report a Medically Unfit Driver – Optometrists.

For more information about mandatory reporting requirements and discretionary reporting authority, see Ontario’s Highway Traffic Act, section 203, and Ontario Regulation 340/94.

Patient involvement

The decision to report a patient is never an easy one. Healthcare practitioners must consider the impact of the decision on the patient within the context of the safety of all road users. Although reporting by certain healthcare practitioners is mandatory, you are encouraged to inform your patient in advance of submitting the report even though you are not required to obtain consent.

It is important for your patient to understand that, in some cases, making such a report is a mandatory requirement. Even when a discretionary report is made, patients should be advised that it is being done in the interest of not only their safety but that of all road users. The patient should also understand that a discretionary report to the Registrar of Motor Vehicles does not always mean a licence suspension.

Information contained in discretionary reports is assessed against national medical standards; where appropriate, additional medical information may be requested.

Medical reporting form

Reminder: New Fitness to Drive Form for physicians, nurse practitioners and occupational therapists

The requirements for reporting fitness to drive changed on July 1. As a result, the updated Medical Condition Report form is now two pages in length.

Please ensure you submit BOTH pages of the completed form, by fax or mail, to the Ministry of Transportation. The ministry cannot process incomplete reports.

Physicians, nurse practitioners and occupational therapists must use the standardized reporting form when they report patients who are unfit to drive. This form has been designed to complement reporting legislation and includes drop down selections for the most frequently reported conditions. The specific conditions under each category are not mandatory; they are examples of some of the most frequently reported high risk conditions that warrant a licence suspension. They are included for ease of completion by the reporting practitioner. Each section also includes an ‘Other’ option so that the practitioner can report any high risk condition that is not listed.

Under the law prescribed practitioners are required to report;

  • The name, address and date of birth of the person being reported,
  • The condition or impairment diagnosed or identified by the person making the report,
  • A brief description of the condition or impairment, and
  • Any other information requested by the form.

To get copies of the Medical Condition Report form:

You can save a link to the form on your computer to access it in the future. To make sure the form can be read, please do not photocopy it.

Note: This form is not intended for drivers who want to upgrade their driver's licence or for commercial drivers filing their re-examination report. Standard medical report forms are available through DriveTest.

How to complete the form

To complete the form:

  • complete it on your computer – when you complete the patient information on page 1 it will automatically populate the same information on page 2
  • if you are reporting a mandatory condition click the box beside the medical condition(s) you are reporting. In some cases you will have to click two boxes – for example – if you are reporting a seizure due to alcohol withdrawal you will click ☑ Seizure due to: ☑ Alcohol Withdrawal
  • complete Section 7 if you are making a discretionary report of a condition that is not listed as mandatory but may make it dangerous for your patient to drive
  • complete Part 3 – Practitioner’s Information
  • print it
  • sign it

How to submit the form

Fax or mail the completed form. Keep a copy for your records. If you submit the report by fax, please do not mail the original.

By mail:

Ministry of Transportation
Registrar of Motor Vehicles
Driver Improvement Office
Medical Review Section
77 Wellesley St. W, Box 589
Toronto, Ontario M7A 1N3

By fax: 416-235-3400 or 1-800-304-7889

Patient access

The Freedom of Information and Protection of Privacy Act (FIPPA) requires the ministry to provide your patient with a copy of the report if they request it.

If you're concerned that releasing the report would threaten someone's health or safety, notify the ministry by:

  • checking the appropriate box on the form
  • calling 416-235-1773 or 1-800-268-1481

How the ministry determines licence status

To determine an individual's licence status, the ministry considers:

  • the details of the condition or functional impairment reported by the healthcare practitioner
  • any mandatory requirements (e.g. vision or hearing standards for certain licence classes)
  • national medical standards

The ministry may seek the advice of the Medical Advisory Committee if:

  • national medical standards don't have sufficient detail
  • the medical information provided is complex, with multiple conditions and/or test results

Role of healthcare practitioners reporting

The ministry relies on information provided by healthcare practitioners to help identify individuals who are at significant risk so that immediate action can be taken.

This includes suspending the licence of any individual reported to have a high risk - chronic or deteriorating - condition that has resulted in:

  • impaired judgment, problem solving, planning and sequencing
  • sudden incapacitation
  • motor or sensory impairment affecting muscle strength and control
  • impaired vision
  • uncontrolled substance use disorder
  • acute psychosis, severe abnormalities of perception or suicidal plan involving a vehicle

Other reports of conditions not deemed to be high risk (e.g. a discretionary report) do not always result in a licence suspension. If an individual is reported to have a medical condition or functional impairment that is well controlled, the ministry won't necessarily suspend their licence.

Where the stability of a condition is questionable, the ministry may request:

  • follow-up medical information
  • a functional assessment of the individual with an occupational therapist
  • other appropriate assessments

National medical standards

The Canadian Council of Motor Transport Administrator's national medical standards provide detailed information for physicians and licensing authorities to help provide for a fair and consistent approach to decision-making.

Visit the CCMTA website for more information and to access the national medical standards.

Functional assessments

Individuals with certain medical conditions or functional impairments may need to undergo a formal functional assessment with an occupational therapist (OT).

The assessment includes:

  • an in-clinic evaluation conducted by the OT
  • an on-road evaluation with the OT and a qualified driving instructor

These assessments are not funded by the Ontario Health Insurance Plan (OHIP) or by the Ministry of Transportation. Payment is the sole responsibility of the individual being assessed.

Individuals with certain visual field defects may also need to undergo a functional assessment.

Approved functional assessment centres

Condition-specific forms

The ministry is exploring electronic reporting to make the medical reporting process more efficient. Part of this process includes developing condition-specific forms for use when additional information is needed.

These forms allow the ministry to collect only the necessary information to determine whether a patient meets the medical standards for driving. They are based on medical standards found in the most recent edition of Determining Driver Fitness in Canada, developed by the CCMTA. A driver will be sent a condition specific form to be completed by their treating physician or nurse practitioner based on information provided in an initial report.

Patient’s Appeal Procedures

All medical licence suspensions can be appealed to the Licence Appeal Tribunal, however, suspensions for failing to meet mandatory vision standards cannot. For more information on the appeal process your patient can call (416) 314-4260 or 1-800-255-2214. You can also visit the Tribunal’s web site.

Fact Sheets

Contact the ministry

By mail:

Ministry of Transportation
Driver Improvement Office
Medical Review Section
77 Wellesley St. W, Box 589
Toronto, Ontario M7A 1N3

By phone: 416-235-1773 or 1-800-268-1481 (within Ontario)

By fax: 416-235-3400 or 1-800-304-7889

By email: drivermedicalreview@ontario.ca

Business hours: 8:30 a.m. to 5 p.m., Monday to Friday

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