This guide is to assist health practitioners in assessing the fitness to drive of any individual. It also sets out the responsibilities and obligations of health practitioners.
Date . . . . . . . . . . . . . .
NZ Transport Agency
C/- Chief Medical Adviser
Transport Registry Centre
Private Bag 11777
Palmerston North 4442
Attn. Chief Medical Adviser
Notification under section 18 of the Land Transport Act 1998
As per my obligations under section 18 of the Land Transport Act 1998, I am writing to advise that I have a patient whom I have advised not to drive, or to drive subject to certain conditions, and I do not consider that the patient is following this advice. The patient is therefore a risk to public safety by continuing to drive.
Postal address if applicable:
Date of birth
The background to my decision to notify the Agency is [please include the condition the individual has, the potential impacts on road safety, and any other matters that provide a broad background to the decision to notify the Agency, eg the patient says they will continue driving, has been seen driving or is generally non-compliant with medical advice]: [If appropriate, eg individual should have a specialist assessment] I consider that further assessment is necessary, and recommend that . . .
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Name and address