Vehicle Industry Registration Procedures Manual

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Section 22 of 38

Chapter 21: Special Plates

21.075 Disabled Person Certification (VC §§5007, 22511.55, 22511.59)

Certification—A properly completed Application for Disabled Person Placard or Plates (REG 195) form is required for Disabled Person License Plates and/or a Disabled Person placard. The certification of the applicant’s disability must be completed as follows:

If the Applicant Suffers FromThe Certification Required Is
A lung diseaseSections 6 and 6A of the REG 195 must be completed by a:
• Physician (items 2–8 only).
• Surgeon (items 2–8 only).
• Physician’s assistant (items 2–8 only).
• Nurse practitioner (items 2–8 only).
• Certified nurse midwife (items 4–7 only).
• Podiatrist (items 4–7 only).
• Chiropractor (items 6–8 only).
A cardiovascular disease
A diagnosed disease or disorder which substantially impairs or interferes with mobility
A severe disability in which they are unable to move without the aid of an assistant device
A significant limitation in the use of lower extremities
The loss or loss of use of one or more lower extremities and does not apply in person
The loss or loss of use of both hands and does not apply in person
Central visual acuity that does not exceed 20/200 in the better eye, with corrective lensesSections 6 of the REG 195 must be completed by a:
• Doctor who specializes in diseases of the eye.
• Optometrist.
The loss of one or more lower extremities or both hands and applies in personSection 6A DMV USE ONLY of the REG 195 may be completed by a DMV employee.

The certification must include the medical license number and signature of the authorized medical provider from California or another state.

Certification by a medical provider located and licensed in another country is acceptable only if the customer is applying for a DP travel placard.

The medical provider’s medical license number must be keyed in the MISC field on the RO/LO screen.