Texas Form DL-101 is the one-page Physician/Psychiatrist’s Statement you use to add a “Communication Impediment” or “Deaf or Hard of Hearing” notation to your Texas driver license or ID card. You fill in the patient section, a licensed physician or psychiatrist completes the medical section, and you bring the original signed form to a scheduled appointment at a DPS driver license office along with a replacement application and the $11 fee.1Department of Public Safety. Communication Impediment with a Peace Officer Once processed, the notation prints on the front of your card and flags the Texas Law Enforcement Telecommunication System when an officer runs your plate or license, so the officer knows before approaching that you may need extra time or communicate differently.2Office of the Texas Governor. Texas Driving with Disability
The notation is voluntary. Texas Transportation Code Section 521.142(h) provides the space on the license application, but no one is required to disclose a health condition.3State of Texas. Texas Transportation Code 521.142 – Application for Original License
Who Qualifies for the Indicator
Form DL-101 lists specific conditions under each of the two indicators. Your physician or psychiatrist identifies which one applies, so you don’t have to sort it out yourself, but knowing the list ahead of time tells you whether the form is worth pursuing.
The “Communication Impediment” indicator covers conditions where a person needs more time to respond to a peace officer:4Texas Department of Public Safety. Physician/Psychiatrist’s Statement Form DL-101
- Autism, including Asperger Syndrome
- Mild intellectual disability
- Down syndrome
- Parkinson’s disease
- Speech and language disorders: mutism, stuttering, speech delay, aphasia, and spasmodic dysphonia
- Post-traumatic stress disorder
- Brain injury
- Cerebral palsy
The “Deaf or Hard of Hearing” indicator covers people who are deaf or hard of hearing and communicate through visual language or assistive technology.4Texas Department of Public Safety. Physician/Psychiatrist’s Statement Form DL-101
If your condition doesn’t appear on either list, the form itself notes an alternative: you can write your physician’s phone number and a directive on the back of your physical card. That does not require DL-101 or a DPS visit, and it does not trigger an electronic alert.
Filling Out the Form
Download the form from dps.texas.gov, print it, and complete your section before the medical appointment so your doctor only has to fill in their half.4Texas Department of Public Safety. Physician/Psychiatrist’s Statement Form DL-101
Your Section
Enter your first, middle, and last name exactly as they appear on your current license or ID. Add your eight-digit DL or ID number from the front of the card. Sign and date. There are no medical questions in the patient section.
The Physician or Psychiatrist Section
A licensed physician or licensed psychiatrist enters their name, office address, office telephone number, medical license number, and the state where they are licensed. In the “Patient’s Medical Condition” field, they write the specific qualifying diagnosis, then sign and date. A nurse practitioner, therapist, or other provider cannot complete this section; the statute specifies a licensed physician or licensed psychiatrist.1Department of Public Safety. Communication Impediment with a Peace Officer
Submitting the Form at a DPS Office
You cannot mail Form DL-101 or submit it online. The original signed form must be presented in person at a DPS driver license office during a scheduled appointment.1Department of Public Safety. Communication Impediment with a Peace Officer Texas DPS offices operate by appointment, though same-day slots are sometimes available. Book through the DPS online appointment system before you go.5Texas Department of Public Safety. Driver License
Bring the following to your appointment:
- The completed Form DL-101, signed by both you and your physician or psychiatrist
- A replacement application, because adding the indicator changes the front of your card and DPS processes it as a replacement transaction
- An identity document such as your current Texas driver license, U.S. passport, or birth certificate; if you have not previously provided proof of U.S. citizenship or lawful presence and your Social Security number, bring those too
At the counter, a license and permit specialist reviews the form, takes your thumbprint and a new photo, and processes the fee. A replacement driver license costs $11, and a replacement ID card also costs $11. If you happen to be applying for an original or renewal at the same visit, the standard fees apply instead ($33 for a driver license ages 18–84, $16 for an ID card ages 59 and younger), and the indicator prints on your new card from the start.6Texas Department of Public Safety. Driver License Fees
After the Appointment
You leave with a temporary paper receipt that acts as your valid license until the permanent card is manufactured. The new plastic card, with “Communication Impediment” or “Deaf or Hard of Hearing” on the front, arrives by mail at the residential address DPS has on file. The DL-101 itself becomes a confidential driver record document under Chapter 730 of the Texas Transportation Code and is not publicly accessible.4Texas Department of Public Safety. Physician/Psychiatrist’s Statement Form DL-101
If you later want the indicator removed, request a replacement license or ID without the notation at your next renewal or during a standard replacement visit. Removal is voluntary too, and the same $11 replacement fee applies.
Common Reasons the Form Gets Rejected
The usual snag is an incomplete form. If your doctor left the medical license number blank or forgot to sign, the specialist cannot accept it and you’ll need to reschedule after the form is corrected. Check both sections before leaving the doctor’s office. Another frequent problem is bringing a photocopy; DPS wants the original with wet signatures.
Parents and guardians can accompany someone with a qualifying condition to the appointment, but the patient section still requires the license or ID holder’s own signature. If the applicant cannot sign, contact the DPS office in advance about alternative signature accommodations.