HSMV 83390: Florida Application for Sunscreening Medical Exemption

The Application Type is Original, Duplicate or Lost-in-transit.

Instructions vary by application type. Refer to the application type selected on the top of the application for the appropriate instructions.

In Section 1, enter the Registrant's Name as It Appears on Driver License (First, Full Middle/Maiden, & Last Name), Phone Number (Voluntary), Email (Voluntary), Sex, Date of Birth, FL DL/ID or FEID/Suffix Number, Mailing Address and Residential Street Address, each address with City, State and Zip Code.

In Section 2, provide the full printed name of the individual with the medical condition, as Applicant's Name as It Appears on Driver License (First, Full Middle/Maiden, & Last Name). This individual may be different from the registered owner.

In Section 2, the applicant certifies to be a person with one of the medical conditions (Lupus, Dermatomyositis, Albinism, Total or Facial Vitiligo, Xeroderma Pigmentosum, or other Autoimmune Disease or other medical condition which requires a limited exposure to light), and to qualify for the medical exemption certificate provided for in Section 316.29545, Florida Statutes. Under penalties of perjury, the applicant declares that the applicant has read the foregoing document of Section 2 and that the facts stated in it are true, then signs on the Signature of Applicant with Medical Condition line with the Date.

In Section 3, list each vehicle to be equipped with sunscreening material, with its Title Number, Vehicle Identification Number (VIN), Year and Make.

In Section 4, enter the Print/Type Name of Certifying Authority, the Physician's Certification or License Number (Required), and the Business Street Address, City, State and Zip Code.

In Section 4, in the professional opinion of the certifying authority, the person named in Section 2 is afflicted with one of the following medical conditions: Lupus (with positive ANA titer), Dermatomyositis (with positive ANA titer), Albinism, Total or Facial Vitiligo, Xeroderma Pigmentosum, or other Autoimmune Disease or other medical condition which requires a limited exposure to light. In Section 4, if other is selected, diagnosis must be provided on the line after other.

The certifying authority states that the condition qualifies the person, pursuant to section 316.29545, Florida Statutes, to have sunscreening material on the windshield, side windows, and windows behind the driver, and that the person is exempt from sections 316.2951-316.2957, Florida Statutes. Under penalties of perjury, the certifying authority declares that the certifying authority has read the foregoing document of Section 4 and that the facts stated in it are true, then signs on the Signature of Certifying Authority line with Telephone Number and Date.

Requirements for an Original application: Form HSMV 83390, Application for Sunscreening Medical Exemption, accurately completed, including the "Physician's Statement of Certification," which must be completed and signed by one of the following authorities: Physician licensed to practice under Chapters 458, 459, or 460, Florida Statutes. Dermatologist licensed to practice under Chapter 458, Florida Statutes. Physician who practices medicine in a military medical facility, state hospital or federal prison. The physician must include the name and address of the facility. An advanced registered nurse practitioner licensed under Chapter 464, under the protocol of a licensed physician. Physician assistant licensed under chapter 458 or 459, Florida Statutes.

One of the following proofs of identification is required: A photocopy of a current Florida Driver License. A photocopy of a current Florida Identification Card.

Fees for each applicable vehicle: $6.50 (checked October 20, 2026).

Form HSMV 83390, Application for Sunscreening Medical Exemption, accurately completed. The "Physician's Statement of Certification" section does not have to be completed. For a Duplicate application, the checkbox for "Duplicate" must be checked on the top of the form; for a Lost-in-transit application, the checkbox for "Lost-in-transit" must be checked.

Duplicate fees for each vehicle: $6.50 (checked October 20, 2026).

No fee is charged for issuing a replacement when the certificate has been lost-in-transit and a completed application is submitted within 180 days of the current issue date.

Submit this form to: Bureau of Motorist Compliance, 2900 Apalachee Pkwy, Mail Stop 97, Tallahassee, FL 32399.