DL 145 is the Virginia DMV form you use to apply for a traumatic brain injury designation on your driver's license. The applicant fills in the personal and injury details, and a physician, nurse practitioner or physician's assistant completes the medical assessment. On this page you can fill out the form online on FillingPDF and download or print the completed PDF; the Virginia Department of Motor Vehicles (DMV) publishes the original at the official source link, and the completed form goes to a DMV customer service center with the DL 1P.
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What is DL 145?
Form DL 145, Traumatic Brain Injury Designation Application, is the Virginia DMV form used to apply for a traumatic brain injury designation on a driver's license. A physician, nurse practitioner or physician's assistant completes the medical assessment on it.
The form has three parts. The first, Applicant Information, identifies the person with the disability: full legal name, DMV number or Social Security number, birth date, residence and mailing addresses, and a daytime or cell phone number. The second, Injury Information, records the date and type of injury. The third, the Licensed Physician/Physician Assistant/Nurse Practioner Medical Assessment, is the clinician's part. It lists impairments such as visual field cut, residual weakness (right or left), seizure treatment required, slurred speech and altered gait. It also covers the areas in which driving ability is likely to be impaired, whether the condition is stable, whether the patient follows treatment, medication side effects, and whether the patient is medically capable of safely operating a motor vehicle or a motorcycle.
The clinician also marks what the patient needs, such as a DMV retest (knowledge, road or both), a driver evaluation with a certified independent driver rehabilitation specialist (CDRS), an adaptive device or a prosthetic/orthotic device. Additional recommended restrictions, medications, and the clinician's license details and signature close the form.
The printed revision is DL 145 (07/01/2020). For questions about completing the medical page, the form directs you to Medical Review Services at 804 367-6203.
Who needs to file DL 145?
People who want a traumatic brain injury designation added to their Virginia driver's license use Form DL 145. The form calls the applicant the "person with disability" and says it is used to apply for the designation.
The medical assessment cannot be completed by the applicant. The form's instructions say it must be completed by a physician, nurse practitioner or physician's assistant, who prints their name and medical specialty, gives their medical license number, expiration date and issuing state, and signs and dates the form.
The form must go to the DMV together with the DL 1P. If the residence or mailing address you enter differs from what DMV already has on file, the form also tells you to complete an Address Change Request (ISD 01).
When to file DL 145
Use Form DL 145 when you are ready to apply for a traumatic brain injury designation on your driver's license, once a physician, nurse practitioner or physician's assistant has examined you and completed the medical assessment. The form prints no separate due date.
It is not filed on its own: the instructions say to submit it to a DMV customer service center along with the DL 1P, so both go in at the same time. If you enter an address different from the one in DMV's system, complete the Address Change Request (ISD 01) as well. For questions about the medical page, call Medical Review Services at 804 367-6203.
Documents you need
- DL 1P: submit it to the DMV customer service center together with the completed Form DL 145.
- Address Change Request (ISD 01): complete it only if the residence or mailing address you enter differs from what is currently on DMV's system.
How to fill out DL 145
Enter applicant identity details
In Applicant Information, enter the full legal name (last, first, middle, suffix), your DMV number or Social Security number, and your birth date in mm/dd/yyyy format.
Enter residence and contact details
Fill in the current residence address, city, state and ZIP code, the city or county of residence, and a daytime or cell phone number. If the address differs from DMV's records, also complete Address Change Request (ISD 01).
Add a mailing address if different
Complete the mailing address, city, state and ZIP code only if it differs from the residence address.
Record the injury information
Enter the date of injury in mm/dd/yyyy format and the type of injury.
Check the patient's impairments
The clinician checks each impairment that applies: visual field cut, residual weakness (right or left), seizure treatment required, slurred speech or altered gait.
Mark the driving limitation areas
The clinician checks each area in which driving ability is likely to be impaired, such as judgment and insight, reaction time, range of motion or use of arm(s) and/or leg(s).
Answer the stability and treatment questions
The clinician answers YES or NO on whether the condition is stable, whether the patient is compliant with treatment, and whether medication side effects are likely to impair driving, explaining where the form asks.
Answer the driving capability questions
The clinician answers YES or NO on whether the patient is medically capable of safely operating a motor vehicle and, separately, a motorcycle.
Mark what the patient needs
The clinician checks each item that applies: DMV retest on knowledge, road or both, a driver evaluation with a CDRS, an adaptive device or equipment, or a prosthetic/orthotic device.
Add restrictions and medications
Enter any additional recommended restrictions and the patient's medications in the spaces provided.
Complete the clinician's details
Print the clinician's name and medical specialty, then enter the medical license number, expiration date (mm/dd/yyyy), issuing state, telephone number and fax number.
Sign, review and download the PDF
The clinician signs and dates the form. Check every section, then download or print the completed PDF from FillingPDF and take it to a DMV customer service center with the DL 1P.
How to submit DL 145
Submit the completed Form DL 145 in person at a DMV customer service center, together with the DL 1P. The form names no other channel, mailing address or portal.
- Customer service center: bring the form with the clinician's medical assessment completed, signed and dated, plus the DL 1P.
- Address change: if the residence or mailing address on the form differs from what DMV has on file, complete an Address Change Request (ISD 01).
- Questions: Medical Review Services at 804 367-6203 can clarify any item on the medical assessment.
FillingPDF lets you fill out and download the PDF; submission follows the DMV channels above.
Common mistakes to avoid
- Submitting Form DL 145 to a DMV customer service center without the DL 1P, which the instructions say must accompany it.
- Completing the medical assessment yourself instead of having a physician, nurse practitioner or physician's assistant complete it.
- Entering a residence or mailing address different from DMV's records without completing an Address Change Request (ISD 01).
- Leaving the clinician's name, medical license number, expiration date, issuing state, signature or date blank.
- Answering No on stability or treatment compliance, or Yes on medication side effects, without the explanation the form asks for.
- Writing dates in a format other than mm/dd/yyyy for birth date, date of injury, license expiration or signature date.
- Checking only one of the two vehicle-capability questions: the form asks separately about operating a motor vehicle and operating a motorcycle.
Frequently asked questions
What is DL 145 used for?
DL 145 is the Virginia DMV Traumatic Brain Injury Designation Application. You use it to apply for a traumatic brain injury designation on your driver's license, with a medical assessment completed by a physician, nurse practitioner or physician's assistant.
Who has to complete the medical assessment on DL 145?
A physician, nurse practitioner or physician's assistant. The form's instructions say it must be completed by one of them, and that clinician signs and dates it and gives their license number, expiration date and issuing state.
Where do I submit DL 145?
Submit the completed form to a Virginia DMV customer service center along with the DL 1P. The form does not print a mailing address or an online option, so confirm any other option with DMV.
Do I need another form with DL 145?
Yes, the DL 1P must go in with it. You also need an Address Change Request (ISD 01) if the residence or mailing address you enter differs from what is currently on DMV's system.
Who can I call with questions about the medical page?
The form directs questions to Medical Review Services at 804 367-6203. Call that number for clarification on any item of the medical assessment, such as impairments, limitations or retesting.
Can I fill out DL 145 online?
You can fill out the DL 145 PDF online on FillingPDF and download or print it. FillingPDF is independent of the DMV and does not file the form; you take it to a DMV customer service center yourself.
What can the clinician recommend on DL 145?
The clinician can check that the patient needs a DMV retest (knowledge, road or both), a driver evaluation with a certified independent driver rehabilitation specialist, an adaptive device or equipment, or a prosthetic/orthotic device, and can add recommended restrictions.
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