New Hampshire Code of Administrative Rules
Saf - Department of Safety
Subtitle Saf-C - Commissioner, Department of Safety
Chapter Saf-C 1000 - DRIVER LICENSING
Part Saf-C 1015 - MEDICALLY RECOGNIZED DISORDER DESIGNATION
Section Saf-C 1015.01 - Medically Recognized Disorder Indication

Universal Citation: NH Admin Rules Saf-C 1015.01

Current through Register No. 40, October 3, 2024

(a) Pursuant to RSA 263:41-b, an applicant for a driver license or non-driver identification card may apply to have a medically recognized disorder displayed on their driver license or non-driver identification card. Only medical disorders authorized by RSA 263:41-b, III, shall be displayed on a driver license or non-driver identification card.

(b) An applicant for a medically recognized disorder designation shall complete and submit form DSMV 643 "Medically Recognized Disorder Indication," (rev. 06/23).

(c) By signing and dating the application under penalty of unsworn falsification, the applicant authorizes the division to add the indication of the selected medical disorder pursuant to RSA 263:41-b, III to their driver license identification card.

(d) On form DSMV 643, the applicant shall provide a licensed physician's certification confirming the applicant's recognized medical condition. The certification shall be signed and dated within 60 days prior to the submission of the applicant's application.

(e) By signing and dating form DSMV 643 under penalty of unsworn falsification, the licensed physician is certifying that the applicant is under the licensed physician's treatment and care for the diagnosed designated medical condition.

(f) Upon receipt of a completed form DSMV 643, in compliance with this section, an applicant shall be given a 60-day temporary driver license or non-driver identification card bearing the approved medically recognized disorder indication.

(g) An applicant who receives a 60-day temporary driver license or non-driver identification card as provided in (e) above, shall thereafter receive by mail a driver license or non-driver identification card bearing the approved medically recognized disorder indication.

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