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Driving Assessment Referral Form

Before filling in the form

Please fill out the form with as much detail as possible. If you have difficulty completing this referral form please contact the RDAC for assistance on 0300 300 2240. When you have completed the online form you can pay online using Paypal. All major credit cards are accepted.

Things you will need to complete this form

  • Patient details
  • Medication details
  • Credit card information