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DLD 23A Request for Re‑Evaluation Fillable Form

  1. Language English
  2. Country USA
  3. Activity Driver's License
  4. State Nevada
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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  • Submitting an outdated physician’s affidavit: Ensure the document is dated within the last 30 days.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.

FAQ
  • Who can submit a DLD 23A form?

    The driver, a legal representative, or an authorized third party may complete and submit the form on behalf of the driver.

  • Is an electronic signature accepted?

    Yes. Formize’s PDF Filler provides a compliant electronic signature that the Nevada DMV accepts.

  • What if I don’t have a physician’s affidavit?

    You must obtain a signed affidavit from a qualified physician stating the need for a re‑evaluation before the form can be processed.

  • Can I save my progress and finish later?

    The Formize filler lets you save a draft to your device and resume later, but be sure to complete and submit before the form expires.

  • How long does the DMV take to review the form?

    Processing times vary, but most requests are reviewed within 10‑14 business days after receipt.

  • Do I need to print the form after filling it online?

    Printing is optional; you can email the generated PDF directly to the DMV or upload it through their portal.

  • Is there a fee to submit DLD 23A?

    No, the DLD 23A request for re‑evaluation is free of charge.

  • What if I make a mistake after submitting?

    Contact the Nevada DMV to request a correction. You may need to submit a new DLD 23A with the corrected information.

HOW TO

How to fill out DLD 23A form for free, online in 5 easy steps:

  1. 1
    Click "Fill out this form"
    Press the button on this page to launch the Formize PDF Filler.
  2. 2
    Wait for the filler to load
    A few seconds later the fillable PDF will appear in your browser.
  3. 3
    Enter the required information
    Complete each field; required fields are highlighted in red.
  4. 4
    Upload supporting documents
    Attach the physician’s affidavit and any other evidence using the upload button.
  5. 5
    Submit and download
    Review, sign electronically, and click Submit to get a secure PDF copy.
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ABOUT

Driving License Application Forms

DLD 23A form is one of Driver's license forms that are documents used in the process of obtaining or renewing a driver's license, which is an official government-issued document that permits individuals to operate a motor vehicle on public roads. These forms may vary depending on the jurisdiction, but they generally include the following:

Application Form: This form is used to apply for a driver's license and typically asks for personal information such as name, address, date of birth, and Social Security number.

Identification Documentation: Along with the application form, individuals are usually required to provide specific identification documents to prove their identity, residency, and legal presence in the country. These may include a valid passport, birth certificate, Social Security card, or other government-issued identification.

Proof of Residency: Many jurisdictions require applicants to provide proof of residency, such as a utility bill, lease agreement, or bank statement, to verify their address.

Medical Examination Form: Some jurisdictions may require a medical examination to ensure that the applicant meets the necessary physical and mental requirements for safe driving. A medical professional typically completes this form.

Driver's Education Completion Form: For first-time drivers, completion of a driver's education program may be required. A form or certificate indicating successful completion is often necessary to apply for a driver's license.

Vision Test Form: A vision test is commonly conducted during the driver's license application process. An eye care professional or authorized personnel will assess the applicant's visual acuity and complete the required form.

These forms are typically available at the local Department of Motor Vehicles (DMV) or equivalent government agency responsible for driver licensing. It's important to check the specific requirements and forms applicable to your jurisdiction, as they can vary.

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