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Law Enforcement Electronic Request For Driver Evaluation (eDA-88)

Law Enforcement Electronic Request For Driver Evaluation (eDA-88)

Michigan Department of State

Driver Assessment Section

P.O. Box 30810, Lansing, Michigan 48909-9832

Email: MedicalForms@Michigan.gov

Phone: 517-335-7051 Fax: 517-335-2189

As provided by Section 257.320 of the Michigan Vehicle Code, the Department of State may conduct a reexamination of a person if there is reason to believe that the person is incompetent to drive a motor vehicle or is afflicted with a mental or physical infirmity or disability rendering it unsafe for that person to drive a motor vehicle. Please provide a description of a medical episode, incident, pattern of behavior or other evidence that you believe justifies an evaluation of an individual as it relates to their ability to drive safely.  This form is for Law Enforcement only.  All others, please submit a signed Request for Driver Evaluation (DA-88) form.

All fields are required unless labeled as optional.

Section 1: Driver's Information

Section 2: Why the Driver Should be Evaluated

Section 3: Requestor's Information

Please note that once submitted you will not be able to print a copy for your records.