The extended road test in Florida is a behind-the-wheel evaluation the Department of Highway Safety and Motor Vehicles (FLHSMV) orders when it has reason to believe a current license holder’s physical or mental condition may affect safe driving. It runs longer than the standard Class E skills test and focuses on how you handle sustained, real-world traffic rather than a brief loop. The result can leave your license intact, add restrictions, or end your driving privileges altogether.
Why You Were Referred
The FLHSMV opens a medical review after it receives information suggesting a driver may no longer be fit to drive. Under Florida Administrative Code Rule 15A-5.002, that information can come from a crash report pointing to a physical or mental condition, a medical referral form, a report filed under Florida Statute 322.126, or a request for reconsideration from a prior review.1Cornell Law Institute. Florida Administrative Code Ann. R. 15A-5.002 – Report of Deficit or Disorder to the Department
Any physician, person, or agency can file a written report with the department identifying a driver by name, date of birth, and address and describing the condition of concern. Age alone is not valid grounds. Conditions that commonly prompt a review include seizures, blackouts, strokes, cardiac events, dementia, significant vision problems, and medications that impair alertness or coordination.2Florida Department of Highway Safety and Motor Vehicles. Report An Unsafe Driver A pattern of at-fault crashes can also trigger one, even without a specific diagnosis on file.
The Notice and What It Requires
Florida Statute 322.221 requires the department to give you at least five days’ written notice before a reexamination. The notice tells you what triggered the review and what you need to do. The department may also require you to submit medical reports to the Medical Advisory Board at your own expense, and in cases where the evidence suggests an immediate safety risk, it can suspend or revoke driving privileges while the review is pending.3The Florida Legislature. Florida Statutes 322.221 – Department May Require Reexamination
Medical Paperwork
You will need a physician to complete the FLHSMV medical report form, which is available on the department’s website. The form asks the doctor to describe your diagnoses, medications, and any functional limitations that could affect driving. The physician most familiar with your medical history should fill it out, because the examiner uses it as a baseline for what to watch for on the road. Incomplete or outdated paperwork delays the whole process.
The Vehicle You Bring
Bring a car that is safe and road-legal. It needs working headlights, turn signals, brake lights, horn, mirrors, wipers, and brakes. Doors must open from inside and outside, seats must be stationary, and the glass cannot be cracked in a way that blocks visibility. Current Florida registration and proof of insurance are required at check-in. If the examiner spots a mechanical problem during the pre-test inspection, the appointment gets rescheduled on the spot. Check everything before you leave the house.
What Happens During the Test
The test is given at an FLHSMV service center set up for medical driving evaluations. After staff verify your identification, medical paperwork, and vehicle, an examiner rides along on a route designed to put you in real traffic.
You will be judged on the same fundamentals as any road test: smooth braking, lane position, correct signaling, and reading and responding to signs. The examiner also watches closely for signs of fatigue, confusion, or physical limitation. The route runs longer than a standard Class E test so the examiner can see how you handle sustained driving rather than a short neighborhood loop. Expect multi-lane intersections, lane changes, three-point turns, and parallel parking.
Every decision you make is documented. It isn’t a conversation. After the drive, the examiner usually tells you whether you passed or failed before you leave, then sends a detailed report to the department for the final administrative decision on your license.
Possible Outcomes
Working from the examiner’s report and your medical records, the FLHSMV issues one of three decisions.
Full Reinstatement
If your performance shows your condition does not meaningfully impair your driving, your full privileges are restored. Depending on the condition, you may still be subject to periodic medical reviews going forward.
Restricted License
Florida Statute 322.16 gives the department broad authority to tailor restrictions to your situation, covering the type of vehicle you may drive, mechanical adaptations such as hand controls, and limits on when or why you may drive.4The Florida Legislature. Florida Statutes 322.16 – Restrictions Common codes printed on the license include:
- Daylight only (Code G): driving only during daylight hours.
- Business purposes only (Code 1): driving limited to work commutes, on-the-job driving, education, church, and medical appointments.
- Employment only (Code H): driving limited to commuting to work and driving required by your employer.
Older licenses may show different letter codes for the same restrictions.5Florida Department of Highway Safety and Motor Vehicles. License Classes, Endorsements and Designations Violating a restriction imposed under the department’s general authority is a moving violation with fines under Chapter 318. Violating a restriction imposed by a court, the Commission on Offender Review, or the Department of Corrections is a second-degree misdemeanor.4The Florida Legislature. Florida Statutes 322.16 – Restrictions Either way, the department can also suspend or revoke the license for a restriction violation.
Revocation
When the evaluation shows a serious safety risk that restrictions cannot adequately address, the department revokes the license. After the examination, the department may suspend or revoke the license as it considers appropriate.3The Florida Legislature. Florida Statutes 322.221 – Department May Require Reexamination The written decision generally arrives by mail.
If You Skip the Test
Ignoring the notice is one of the worst moves you can make. Florida Statute 322.221 is explicit: refusing or neglecting to submit to a required examination or reexamination is itself grounds for suspending or revoking your license.3The Florida Legislature. Florida Statutes 322.221 – Department May Require Reexamination The department does not have to wait for you to fail. If your license is revoked for non-compliance, getting it back means going through the entire medical review from scratch, which is far more burdensome than showing up on the scheduled date.
How to Contest the Decision
If the department suspends, cancels, or revokes your license after a medical review, you can request an administrative hearing. The hearing must be scheduled within 30 days of the request and held in the county where you live unless you and the department agree on another location.6Florida Senate. Florida Statutes 322.271 – Authority to Modify Revocation
At the hearing you can present updated medical evidence showing your condition has improved or that the restrictions are more severe than your situation warrants. You can also argue that losing the license creates a serious hardship by preventing you from working or supporting your family. The department can then affirm, modify, or restore your driving privileges on a restricted basis.6Florida Senate. Florida Statutes 322.271 – Authority to Modify Revocation File the request promptly after you receive the order; delays can leave you without any driving privileges while you wait.