It can be a difficult decision to report a relative, friend or neighbor to the DMV, but concern for the driver’s safety and the safety of others is usually the deciding factor. If you know someone who could be a hazardous driver because of a medical condition, please report this to the DMV by completing a Driver Condition or Behavior Report MV3141.

Please keep in mind that driving is complex. Medical conditions can cause symptoms that interfere with a person’s functional ability to drive safely. A driver’s physical and cognitive (thinking) health are all important factors in assessing this functional ability to drive. Examples of such symptoms include:

• Physical: seizures/loss of consciousness, chronic drowsiness, impaired response time, inadequate vision, severe shortness of breath, side effects of medications, hypoglycemia, etc.
• Cognitive: confusion, memory loss, impaired judgment, impulsive behaviors, delusional thinking, etc.

The DMV cares about a driver's functional ability to safely operate a motor vehicle. Decisions about impaired drivers are based on symptoms and behaviors, rather than the type of condition or a diagnosis. Reporting from citizens, healthcare providers and law enforcement is crucial to keeping our roadways safe.

Ti​ps to filling out the report:

As a private citizen completing the Driver Condition or Behavior Report MV3141​:​

• Complete only the first page of the report. (The second page is reserved for medical professionals, when they use the form.)
• Identify the driver with at least the driver’s name and date of birth.
• Be as specific in your description as possible when reporting your observations. The better our understanding of your concerns, the more likely we will be able to make a good assessment of the driver.
• Reports competed by private citizens must be signed and dated by two people: the reporting person and a second person who can verify the information.
• Return the report to us via email, fax or mail using the contact information found on the form.

W​hat happens after you file the report?

DMV uses the information from your report to determine what action to take. If there is a medical concern, we will ask the driver to file a report to verify medical eligibility. If there’s an operating concern, then we will usually ask the driver to retake driving tests. A license is never cancelled based on your report alone.

Can I remain anonymous?

No. Wisconsin has an Open Records Law, which means that reported information on behavior is available to the reported driver. If this is a concern, you might want to discuss your concerns with the driver and suggest that the person stop driving or see a healthcare provider. The healthcare provider may be willing to send in a report. If you have good reason for maintaining confidentiality and will not provide information otherwise, you may request a Pledge of Confidentiality MV3454. You must sign this form in the presence of a DMV representative before we accept the information. Please understand that confidentiality is not anonymity. DMV will still know your identity as the source of the report, but we will withhold that info from the driver to the extent permitted by law.

Vi​ew other DMV medical forms (including Voluntary Temporary Surrender form)​