If your doctor has mentioned a "Fitness to Drive form" or you've received a letter from Transport for NSW asking you to complete a medical assessment, you're probably wondering what this actually involves and what it means for your licence.

This is a plain-language guide to how the form works, who fills it out, and what happens next.

What is the Fitness to Drive form?

The Fitness to Drive form (sometimes called the medical assessment form, or the Transport for NSW medical form) is a standardised document used in NSW to assess whether a person with a medical condition is safe to continue driving.

It's not a form you fill out yourself. Your doctor completes it based on a clinical assessment of your health, and then it's submitted to Transport for NSW.

The form is used whenever Transport for NSW needs medical evidence to make a decision about your licence. This includes situations where you have a medical condition that may affect driving, when you're renewing your licence after age 75, or when Transport for NSW has received a concern about your fitness to drive.

Who fills out the form?

Your doctor. This is usually your GP, but it can also be completed by a specialist (such as a neurologist, geriatrician, ophthalmologist, or rehabilitation physician) depending on your condition.

Your doctor assesses your medical fitness to drive using the Austroads Guidelines (the national medical standards for driver licensing) and records their findings and recommendation on the form.

You don't fill out the form yourself, but you do need to attend the medical appointment so your doctor can assess you.

How do I get the form?

There are a few ways the form comes into play:

Transport for NSW sends you a letter. If you're over 75, or if Transport for NSW has been notified about a medical condition, they'll send you a letter (usually around 12 weeks before the assessment is due) asking you to have a medical assessment. The letter tells you what type of doctor you need to see.

Your doctor initiates it. If your doctor identifies a new condition or change in an existing condition that may affect your driving, they can complete the form and submit it to Transport for NSW without waiting for a letter.

You request it. If you want to proactively address a medical concern about your driving, you can ask your GP to complete the form.

How your doctor accesses the form. Most GPs can complete and submit the form electronically through their practice management software (via HealthLink). Otherwise, a paper form can be obtained from a Service NSW centre. You can also find a copy of the form here.

What does the form ask?

The form asks your doctor to assess and record information about:

• Your medical condition (diagnosis, severity, stability)

• Your medications

• Your vision

• Your cognitive function

• Your physical function

• Any other factors relevant to driving safety

Based on this assessment, your doctor then makes one of three recommendations:

Meets the medical standards. You're fit to drive. Your licence is renewed or maintained as normal, possibly with conditions (such as "must wear corrective lenses" or "annual review required").

Requires further assessment. Your doctor can't determine your fitness to drive from a consulting room alone, and they recommend an OT driving assessment to evaluate how your condition affects your actual driving.

Does not meet the medical standards. Your condition clearly makes driving unsafe, and your doctor recommends that your licence be suspended or cancelled.

What happens after the form is submitted?

Once your doctor submits the form, Transport for NSW reviews it and takes action based on the recommendation:

If you're cleared: Your licence is renewed or maintained. You may receive conditions on your licence based on your doctor's advice (such as driving with corrective lenses, automatic only, or daytime only). You'll be notified in writing.

If further assessment is needed: Transport for NSW will require you to complete an OT driving assessment before a decision is made about your licence. You may or may not be able to continue driving in the meantime, depending on the circumstances. The letter from Transport for NSW should tell you.

If you don't meet the standards: Your licence may be suspended or cancelled. You'll be notified in writing, and you have the right to appeal the decision.

Where does the OT driving assessment fit in?

The OT driving assessment is the next step when your doctor ticks the "requires further assessment" box on the form. It's the practical, on-road evaluation that answers the question your doctor couldn't answer from the consulting room: is this person's medical condition actually affecting their driving?

The OT assessment doesn't replace the Fitness to Drive form. It builds on it. Your doctor provides the medical context via the form, and the OT provides the functional, on-road assessment. Together, they give Transport for NSW a complete picture.

After the OT assessment, the OT submits their own report to Transport for NSW with a recommendation. Transport for NSW then makes the final decision about your licence.

Common questions

Do I have to pay for the medical assessment? The Fitness to Drive medical assessment with your GP is a standard consultation. It may be bulk-billed, or you may be charged a consultation fee. Ask your GP's reception when you book. The OT driving assessment (if needed) is a separate service with its own fee.

What if I disagree with my doctor's recommendation? You can seek a second medical opinion from another GP or specialist. However, if Transport for NSW has already received a recommendation and acted on it, you'll need to go through their formal process to challenge the decision.

Can I keep driving while waiting for my OT assessment? It depends. In some cases, yes. In others, Transport for NSW may suspend your licence pending the assessment. The letter from Transport for NSW will tell you. If you're unsure, call 13 22 13.

How often do I need a Fitness to Drive assessment? For drivers over 75, it's annual. For progressive conditions (like dementia or Parkinson's disease), your doctor will advise on the review interval, usually annually. For stable conditions, reviews may be less frequent.

What if I don't attend the medical assessment? If Transport for NSW has requested a medical assessment and you don't complete it by the due date, your licence may be suspended until you do.

Starting the process

If your doctor has completed the Fitness to Drive form and recommended an OT driving assessment, you can start the process at steerdriving.com.au/referral. If you've received a letter from Transport for NSW and aren't sure what to do next, your GP is the best first point of contact.

Ready to book an OT driving assessment in Sydney? Steer Driving is a mobile assessment service covering greater Sydney. Whether you already have a referral or you're just getting started, get in touch and we'll guide you through the next steps.

This article was written by Elise, an AHPRA-registered Occupational Therapist and Transport for NSW-registered driver assessor. Elise is the founder of Steer Driving, a mobile OT driving assessment practice in Sydney.

FAQ Section

What is the Fitness to Drive form in NSW? It's a standardised medical assessment form completed by your doctor and submitted to Transport for NSW. It assesses whether a medical condition affects your ability to drive safely and recommends next steps for your licence.

Who fills out the Fitness to Drive form? Your doctor (GP or specialist). You attend the appointment, but the doctor completes and submits the form based on their clinical assessment.

How do I get a Fitness to Drive form? Transport for NSW will send you a letter if one is required (for example, for your annual review after age 75, or if a condition has been reported). Your doctor can also initiate the process. The form is accessed electronically through practice management software or from a Service NSW centre.

What are the possible outcomes of the Fitness to Drive assessment? Your doctor will recommend one of three outcomes: you meet the medical standards (licence renewed), you need further assessment (OT driving assessment recommended), or you don't meet the standards (licence suspension or cancellation recommended).

Do I need an OT driving assessment after the Fitness to Drive form? Only if your doctor recommends one. Many people are cleared by their doctor without needing an OT assessment. The OT assessment is for situations where your doctor can't determine your fitness to drive from a clinical assessment alone.

Can my licence be suspended if I don't complete the Fitness to Drive assessment? Yes. If Transport for NSW has requested a medical assessment and you don't complete it by the due date, your licence may be suspended until the assessment is done.