Or. Admin. R. 735-074-0120 - The Mandatory Report to DMV
(1) To report a severe and uncontrollable functional or cognitive impairment as required by OAR 735-074-0110, the reporting physician or health care provider must complete and submit to DMV a Mandatory Impairment Referral form (DMV form 735-7230).
(2) To report visual acuity or field of vision not meeting DMV standards as required by OAR 735-074-0100, the reporting physician or health care provider must complete and submit to DMV a Mandatory Impairment Referral form (DMV form 7230).
(3) The form must contain the following information:
(a) The name, address, date of birth, sex, and Oregon driver license or identification card number (if known) of the person being reported;
(b) The functional or cognitive impairment(s) being reported, as described in OAR 735-074-0100 or 735-074-0110;
(c) A description of how the person reported is affected by the impairment; and
(d) The name, license or certification number and signature of the reporting physician or healthcare provider.
(4) If available, and applicable, the following information may be included on the form:
(a) Any underlying medical diagnosis or condition related to the reported impairments;
(b) The date of the person's last episode of loss of consciousness or control, date of cerebrovascular accident (CVA), cardiac event or alcohol, cannabis, psilocybin, controlled substance or inhalant use or relapse;
(c) Medication prescribed that may interfere with safe driving behaviors or medication prescribed to treat the impairment(s) reported;
(d) The address and phone number, of the reporting physician or health care provider; and
(e) The date of the person's most recent examination.
Forms referenced are available from the agency.
Statutory/Other Authority: ORS 184.619, 802.010 & 807.710
Statutes/Other Implemented: ORS 807.710
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