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Medical Declaration Form for Current Hire Car Driver Licence Holders

Label
1. Name*
2. Email address*
3. Date of Birth*
4. Have your medical conditions changed since your previous assessment?*
  
  Yes
  
  No
Nochanges
1. I confirm that I have no medical conditions that would affect driving a licensed hire car vehicle since my last medical assessment or since the completion of my last online medical declaration
3. Medical Conditions
4. I confirm I am currently managing previously disclosed health conditions or do not have any relevant medical conditions
5. I confirm I am following government guidance on coronavirus and will cease driving for the required period as required by that guidance
6. Label
Label
Licencingteamdetails
2. Please detail the changes in your medical conditions