CT DMV Form P-142M is the medical report Connecticut uses to decide whether a health condition affects your ability to drive safely. You fill out the patient section, your physician, physician assistant, or advanced practice registered nurse completes the clinical sections after examining you, and you return the signed form to the DMV’s Driver Services Division by the deadline stated in the letter you received. The blank form is a free PDF on the Connecticut DMV website.1CT.gov. Department of Motor Vehicle Forms
Why You Received a P-142M
Connecticut General Statutes § 14-46 lets physicians, physician assistants, advanced practice registered nurses, and optometrists report drivers they have diagnosed with a chronic condition that could impair driving, or with recurring episodes of unconsciousness that medication does not control. When the DMV gets one of those reports, it sends you a P-142M with a cover letter and a return deadline.2Justia Law. Connecticut Code Title 14 Chapter 246 – Section 14-46
A provider’s report is not the only trigger. You might also receive the form after self-reporting a health change at renewal, after a crash that raises a medical question, or after a law enforcement officer flags a concern. If you hold a public passenger endorsement (school bus, student transportation, taxicab, livery, motor bus, or a service bus for ten or more people), the DMV may send a P-142M on top of the standard commercial medical certification when a specific condition is at issue.3CT.gov. Getting Medical Certification for CDL4CT.gov. Apply or Maintain a Public Passenger Endorsement
Where to Download the Form
The P-142M is on the Connecticut DMV forms page at portal.ct.gov. The current revision is dated 04-22. Print it single-sided so your provider has room to write and attach records. If the DMV initiated the review, you should also receive a paper copy by mail with a cover letter setting the return deadline.1CT.gov. Department of Motor Vehicle Forms
Section A: The Part You Complete
Section A is patient information and it is yours. Fill in your full name, date of birth, operator’s license number, mailing address, and phone number. Then sign and date the statement below those fields, which acknowledges consent to the medical examination and authorizes your provider to share records with the DMV.5Connecticut DMV. Form P-142M Medical Report
There is an optional authorization block for naming specific people the Driver Services Division may talk to about your case. It is not required, but it is useful if you want a family member or attorney to communicate with the DMV for you.
Sections B and C: What Your Provider Fills Out
Everything after Section A belongs to your medical examiner: a licensed physician, physician assistant, or APRN. One rule governs the whole clinical portion — the examination must happen within 90 days of the date the provider signs. Anything older is rejected.5Connecticut DMV. Form P-142M Medical Report
Section B: The Overall Assessment
In Section B the provider states whether you are medically qualified to drive, whether they have discussed the condition with you, and whether they recommend a road test. They also indicate whether periodic medical reports should follow, and at what interval. A separate checkbox addresses commercial driver’s licenses and public passenger endorsements. If the provider checks the box stating you are not medically qualified to drive, the form itself warns that your license or license privilege will be withdrawn, and the rest of the form still has to be completed for the condition causing the disqualification.5Connecticut DMV. Form P-142M Medical Report
Section C: Seven Condition Areas, All Required
Section C has seven subsections and every one has to be addressed. For each area the provider either checks “no known condition” and initials next to it, or fills in the clinical details. The seven areas are cardiology; diabetes and metabolic syndrome (including retinopathy and neuropathy questions); neurology, which covers seizure history, altered consciousness, stroke, and traumatic brain injury; orthopedic conditions and whether they are stable or worsening; special equipment and license restrictions, including whether you need hand controls, a prosthetic device, or an automatic transmission, and whether you should complete a driver training program through the Department of Aging and Disability Services; respiratory and sleep disorders such as obstructive sleep apnea, with a question about breath capacity for ignition interlock devices; and psychiatric conditions and substance abuse, including whether treatment is controlling the condition.5Connecticut DMV. Form P-142M Medical Report
Wherever a condition exists, the provider must say whether you have had episodes of lost or altered consciousness, whether you are following the prescribed treatment plan, and whether you can safely operate a motor vehicle despite the condition. They sign under penalty of false statement per Connecticut General Statutes §§ 14-110 and 53a-157b, certifying that the information is accurate and that the examination occurred within the 90-day window.5Connecticut DMV. Form P-142M Medical Report
Attach anything that helps: lab results, imaging, specialist reports. The form specifically says to include relevant technical reports or test results. The single most common reason a P-142M gets returned is a blank subsection in Section C, so check that all seven areas are either filled in or marked “no known condition” with initials before it leaves the office.
Submitting the Form and Meeting the Deadline
Once every section is completed and signed, send the form to the DMV’s Driver Services Division. The mailing address and fax number are on the form and on the DMV cover letter. Mail and fax are the standard channels. Certified mail with a return receipt gives you proof of delivery if the form goes missing. Keep a photocopy or scan for your own records before sending anything.
Timing is the part people underestimate. Your DMV letter sets a specific number of days to return the form, and missing that deadline can result in suspension of your license while the review is still open. Book the medical appointment as soon as the form arrives and, when possible, have your provider examine you and complete the form in the same visit.
What the DMV Does With It
The Driver Services Division reviews the completed P-142M and any attached documentation. Under Connecticut General Statutes §§ 14-46b and 14-46c the DMV may also refer the file to its Medical Advisory Board for an independent look, and the board can ask for additional records before making a recommendation.5Connecticut DMV. Form P-142M Medical Report
The decisions the DMV can reach include a full unrestricted license; a restricted license (common restrictions are daylight-only driving or required special equipment such as hand controls or an automatic transmission); a required road test, especially where the provider recommended one; periodic follow-up P-142M reports at six-month, annual, or other intervals to confirm your condition remains stable; or withdrawal of your license, which happens immediately when your own provider checks the “not medically qualified” box and can also follow a full review.
If Your License Is Suspended
A medical suspension is not necessarily permanent. If your condition improves or stabilizes, you can submit a new P-142M showing that you now meet the state’s health standards, and the DMV will review it (and may send it back to the Medical Advisory Board) before deciding on reinstatement.
Connecticut charges a $175 license reinstatement fee, payable online, by mail, or at a DMV office. Reinstatement is not processed until both the fee and satisfactory medical documentation are on file.6CT.gov. Pay Your License Reinstatement Fee in CT
You can also contest a medical suspension by requesting an administrative hearing, where you can present evidence, including testimony from your physician, that you are safe to drive. The alternative is to skip the hearing and work with your provider on the paperwork route to reinstatement.
When a Different Form Applies Instead
The P-142M is the general medical report. If your situation is narrower, the DMV may direct you to a specialized form instead of, or alongside, the P-142M. The P-142SW (Seizure Medical Report) is for drivers with epilepsy or a seizure disorder and covers Connecticut’s eight-year seizure-free requirement in detail. The P-142OP is completed by an ophthalmologist or optometrist for vision-specific evaluations. The P-142SPE addresses orthopedic limitations and vehicle modifications. The P-142ER is used by emergency room physicians reporting a driver seen after an incident. The P-244 is an affidavit any concerned person can file to report an impaired driver.1CT.gov. Department of Motor Vehicle Forms If one of these fits your case better, the DMV will tell you, and in some situations both the P-142M and a condition-specific form are required.
Bring the form to a provider who knows your medical history. A physician who has treated your condition for years can give a more detailed and credible assessment than an urgent-care doctor seeing you once, and specialist records attached to the primary examiner’s findings tend to make the DMV’s decision easier and faster.