DLD 23A Request for Re‑Evaluation Fillable Form

The DLD 23A Request for Re‑Evaluation is a Nevada Department of Motor Vehicles (DMV) form used when a driver needs a medical re‑examination to determine continued fitness to operate a motor vehicle. Whether you’re a driver, a legal representative, or an authorized third party, you can now complete this form online with Formize’s secure fillable PDF tool.

What Is the DLD 23A Form?

This form must be submitted together with a physician’s affidavit confirming that a re‑evaluation is medically necessary. It is commonly required after a serious injury, a change in health condition, or when a previous evaluation has expired.

How to Complete the DLD 23A Online

Follow the simple steps below to fill the form directly in your browser—no extra software needed.

• Click the "Fill out this form" button on the page.
• Wait a few seconds while the Formize PDF Filler loads.
• Enter the required information in each field. The filler highlights mandatory sections.
• Upload the physician’s affidavit and any supporting documents.
• Review the completed form, then click Submit to generate a secure PDF copy you can email or print.

Common Mistakes to Avoid

• Leaving required fields blank: The filler will flag missing data before you can submit.
• Using the wrong driver’s license number: Double‑check the number printed on the license.
• Submitting an outdated physician’s affidavit: Ensure the document is dated within the last 30 days.
• Not signing the form: The electronic signature field is mandatory for acceptance.

Where to Submit the Completed Form

After you finish, download the signed PDF and send it to the Nevada DMV via the electronic portal indicated on the confirmation page, or mail it to the address listed in the form’s instructions.

FAQs About DLD 23A

Find quick answers to the most common questions below, or scroll down to the full FAQ section.