When this form is submitted to the driver license division, the content will be evaluated and may result in the driver being requested to appear at a field office in order to complete written, vision and driving skills testing. The driver may also be required to submit a Functional Ability Evaluation Medical Report form or a Certificate of Visual Examination form completed by their heath care professional or vision specialist.
At the conclusion of the review exam process, the driver may be granted a restricted driving privilege, or may have their driving privilege denied if unable to meet minimum testing standards.
The form submitted must be notarized and the identity of the person notifying the division shall not be disclosed by the division. It may be punishable as a misdemeanor to knowingly give a written false statement (UCA 76-8-504.)
Click here for the Unsafe Driver Review form.