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Drivers Health Declaration

Drivers Health Declaration

It is an offence for a person to drive on a road, any vehicle otherwise than in accordance with a licence authorising him to drive it.  It is also an offence for a person to cause or permit another person to drive it.

As a Sub-Contractor, I declare that I have produced my latest licence, and that I have no pending convictions, endorsements of disqualifications.

I have had no change in my health, which could affect my entitlement to drive.  In particular, for ALL licences:

  • An Epileptic event (seizure or fit)
  • Sudden attacks of disabling giddiness, fainting or blackouts
  • Severe mental handicap
  • A pacemaker, defibrillator or anti-ventricular tachycardia device fitted.
  • Diabetes controlled by insulin or tablets
  • Angina (heart pain) while driving
  • Parkinson’s disease
  • Any other chronic neurological condition
  • A serious problem with memory
  • A Major or minor stroke
  • Any type of brain surgery or tumour
  • Severe head injury involving in-patient treatment at hospital
  • Any severe psychiatric illness or mental disorder
  • Continuing/permanent difficulty in the use of arms or legs
  • Dependence on a misuse of alcohol, illicit drugs or chemical substances in the past three years (do not include drink/driving offences)
  • Any visual disability that affects both eyes (do not declare short/long sight or colour blindness)

Also, for vocational licences:

  • Any heart condition or heart operation
  • Any visual problem affecting either eye.

If any of the above affects me I will inform my employer as soon as possible.  I understand that I must also inform DVLA by writing to: Drivers Medical Unit, DVLA,  Swansea SA99 1TU.  Failure to do so is a criminal offence punishable by a fine of up to £100.00.  I will inform my employer of any road traffic incidents, convictions, endorsements or disqualifications that occur, which could affect my entitlement to drive, as soon as possible.

Driver declaration:  I have read and fully understand the above and will comply with what is requested of me.

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