Nevada Department of Motor Vehicles · Nevada state form
DMV-23A Request for Re-Evaluation
Use this form to request that the Nevada DMV re-examine a driver to determine whether they can safely operate a motor vehicle.
- What this form is
- This form requests a re-evaluation of a driver’s ability to safely operate a motor vehicle. It asks for the driver’s identifying information and details about the reason for the request, including any incident, witnesses, and occurrence date. The request must be accompanied by an affidavit from a physician who agrees the driver should be re-examined. The requester certifies the statements and may be required to testify at an administrative hearing.
- Who needs it
- A person requesting that a driver be re-examined, with an accompanying affidavit from a physician who agrees with the request.
- Why it needs a notary
- The requester’s signature must be notarized or sworn before a DMV representative; this can be done online with a commissioned online notary.
- How to submit it
- Send the completed request with the required physician affidavit to the Driver’s License Assessment Team, Central Services Division, 555 Wright Way, Carson City, NV 89711.
Questions
Who can request a driver re-evaluation with DMV-23A?
A person may use DMV-23A to request that a driver be re-examined to determine whether they can safely operate a motor vehicle. The request must include an affidavit from a physician who agrees the driver should be re-examined.
Does the DMV-23A signature need to be notarized?
Yes. The requester’s certification must be sworn before a notary public or DMV representative. Notarization can also be completed online with a commissioned online notary.
How do I submit the DMV-23A request?
Send the completed form and the required physician affidavit to the Driver’s License Assessment Team, Central Services Division, at 555 Wright Way, Carson City, NV 89711.