Section I is to be completed by driver. Section II Medical Health is to be completed by MD/DO and/or medical professional (NP/PA).
Conditions: yes or no is required for each condition listed.
Medications: if medications are listed, a condition must be disclosed (in Question #2).
Section V: MD/DO and/or medical professional (NP/PA): failure to provide license information will result in return of form to the driver.
Unacceptable signatures: Chiropractors, Podiatrists, Residents, Fellows, Interns, RN's, LPN's, Co-signatures.
Guidelines: please see guidelines at ilsos.gov, search for Medical/Vision Conditions for completion of form.
| Question | Answer |
|---|---|
| Form Name | DSD DC-163.10 |
| Form Length | 2 pages |
| Fillable? | Yes |
| Fillable fields | 97 |
| Avg. time to fill out | 17 min |
| Edition | February 2026 |
| Issuing agency | Office of the Secretary of State Driver Services Department |
| Valid for | Three months (90 days) |
| Other names | DSD DC-163.10, DC-163.10, DSD DC163.10, Medical Report, Medical Report Form, Illinois Medical Report |
| Official source | DSD DC-163.10 (Rev February 2026), Illinois Secretary of State Driver Services Department |
Medical Report Form isn’t the one you’re looking for?