Referring an Individual for Services

Adult clients should have a current driver’s license or permit upon referral to participate in a comprehensive driver evaluation.

For teens under 18 years of age, a copy of the restricted instruction permit (form SBTS-800 issued by the Driver Education Specialist) validating completion of classroom driver education is required.  Clinical testing of teens with cognitive impairments or special equipment needs can be arranged prior to completion of classroom driver’s education to aid with determining the appropriateness of enrolling the teen in driver’s education.

All Clients must be seizure-free for at least 6 months and provide medical documentation of seizure status if a seizure has been experienced within the last year.

A Physician Referral is NOT required for services, however, the client may provide a doctor’s order for services if one is available.

Contact us at 1-888-888-0039 or 336-697-7841 to discuss services


Select the appropriate referral form below and FAX the completed form to DRS at 336-697-7842


Referral from a Physician’s Office

Referral from a Vocational Rehabilitation Services or Independent Living Program Counselor

Referral from a Worker’s Compensation Case Manager or Adjuster

Referral of self from an Aging Driver or Aging Driver’s Family Member

Referral of a Special Needs Teen Driver