ARIZONA MVD MEDICAL REVIEW

Report an Unsafe Driver in Arizona (Form 96-0469)

Turn direct safety observations into a complete Arizona MVD Medical Review report.

Use this guided walkthrough when you have direct knowledge of a licensed Arizona driver's condition or behavior that may affect safe driving. Docgle helps you identify the driver, select the concern categories, and write the facts MVD needs to review.

Start the walkthrough View the official source

Average time

10-15 minutes

Difficulty

moderate

Best for

People with firsthand observations about a driver's medical, visual, mental, emotional, or unsafe-driving concern

What this form stands for

Give Arizona MVD enough direct, specific information to decide whether medical review or testing may be needed.

Do not guess. AZDOT says the report must be based on direct knowledge and incomplete reports will not be accepted.

What you'll need

Driver name, date of birth, address, and license information if known
Specific incidents, dates, places, accidents, or conditions you directly observed
Your name, address, phone number, and signing date

How the walkthrough is organized

Confirm direct knowledge

Make sure you can report specific facts rather than rumors.

Identify the driver

Collect the driver name, birth date, license details, and address.

Choose concern categories

Select every printed condition or behavior category that fits your observations.

Describe what happened

Write the dates, places, incidents, conditions, and other facts MVD should review.

Sign and submit

Add your contact information, review the report, print it, and sign it.

Ready to start?

Docgle asks calm, plain-English questions and keeps the official source attached for review.

Start arizona-driver-condition-behavior-report-96-0469 walkthrough