Form 4319 – Missouri Driver Condition Report

The Missouri Form 4319, also known as the Driver Condition Report, is required when a driver’s medical, vision, or overall condition may affect safe operation of a vehicle. This form is used by the Missouri Department of Revenue to evaluate whether additional testing or restrictions are needed.

What is Form 4319?

Form 4319 collects detailed information about a driver’s health, recent accidents, and any conditions that could impair driving ability. The report is confidential and is only shared with authorized officials or a court order.

How to Fill Out the Driver Condition Report Online

Instead of downloading and editing the PDF manually, simply click the “Fill out this form” button on this page. The Formize PDF Filler app will load in your browser, allowing you to complete the form directly, save your progress, and submit it electronically.

Common Mistakes to Avoid

• Leaving any required field blank – the filler will highlight missing information before you can submit.
• Signing on the reverse side of the PDF – use the built‑in signature field in the online filler.
• Providing outdated medical information – ensure all health details are current.
• Forgetting to attach supporting documents (e.g., physician’s statement) when required.

Where to Submit the Completed Form

After completing the form, you can:

• Submit electronically through the Formize platform (recommended).
• Print and mail the signed form to the Missouri Department of Revenue, Driver Licensing Division.

Keep a copy of the completed PDF for your records.

Download the Fillable PDF

If you prefer to work offline, you can download the official fillable PDF directly from the Missouri Department of Revenue:

Download Form 4319 (PDF)