Driving support and assessment – Drive Ability North West

You can refer yourself for driving support and advice, or a driving assessment.

Health and social care professionals, the DVLA and Motability can refer people too.

Different from a driving test, the assessment is designed to review your driving and give you an honest opinion of your skills and ability. We know that this may seem daunting, but our Occupational Therapists and Approved Driving Instructors will put you at ease.

People choose to take an assessment for lots of reasons:

• You may want to investigate how you might be able to drive using vehicle modifications because of a physical disability or because you’ve become less able following a stroke, for example
• You might want to check that you’re still able to drive safely following a recent diagnosis of a medical condition, such as dementia
• You may want reassurance as you get older, and your reactions have slowed a little

I want to refer myself

Simply apply online using our referrals forms for both Driving Assessments and Vehicle and Passenger Access Assessments below, or call us on 0300 300 1100.

Self referrals are £80.

I’m a professional wishing to refer an individual

Please apply online using our referrals forms for both Driving Assessments and Vehicle and Passenger Access Assessments below.

Police Fitness to Drive Assessments

We are working with Cheshire Police, Greater Manchester Police and Merseyside Police to support vulnerable road users with an alternative to prosecution.

If you have been offered the alternative to prosecution option and have a Police incident number, the Police will be in touch on how you can book this assessment.

Further details on this scheme can be found on the Driving Mobility website.

Referral forms

You access our Driving Assessment Referral Form below and our Vehicle and Passenger Access Assessment Form on this link.

Whether you’re a professional, or an individual wishing to refer yourself for driving assessment, please use the form below:

Individual's title: *-MrMissMrsMsOther

Individual's name: *

Individual's date of birth (DOB): *

Individual's telephone: *

Individual's email:

Individual's address: *

Individual's postcode: *

Individual's emergency contact name: *

Individual's emergency contact telephone: *

Please select the support, advice or service we can help you with:

• Driving assessment
• Operating driving controls
• Returning to driving after illness
• Advice prior to starting driving
• Referred by the DVLA
• Other

If 'other' please state:

If you have a medical condition that affects your driving please provide details:

Please tell us your current driving status:

• I have never driven
• I am a current driver
• Surrendered licence
• Revoked license

Licence type:

• Full licence
• Section 88
• PDAL
• Provisional

Licence number:

If your licence has any codes in section 12 on the reverse, please add below:

I have been advised not to drive until I have had my driving assessment:

• If yes, please tell us why using the fields below
• If no, please proceed to the type of vehicle question

Years of driving experience:

When did you last drive?

Who advised you not to drive? Please tell us their name, role and contact details below:

What type of vehicle are you driving/recently driven? Tell us the make and model: *

Transmission:

• Manual
• Automatic

Any vehicle adaptations?

Your GP practice name and address:

GP practice telephone number:

GP practice email:

Have you or are you experiencing any of the following? Please tick all of which apply to you):

• Epilepsy
• Speech or reading changes
• Heart problems
• Mental health
• Allergies
• Memory Changes
• Reading or learning for new information
• Blackouts/absence seizures
• Dizziness, fainting or loss of consciousness
• Major operations
• Diabetes - Diet controlled
• Diabetes - Tablets
• Diabetes - Insulin
• Diabetes - Hypoglycaemia (hypos)

If you have ticked any of the above boxes, please give details in the box below:

Following this diagnosis, were you advised not to drive by a Medical Professional?

• Yes
• No
• I’m not sure if I need to

Following this diagnosis, have you informed the DVLA?

• Yes
• No
• I’m not sure if I need to

Referring professional’s title (if applicable):-MrMissMrsMsDrOther

Referring professional’s name and designation:

Referring professional’s email:

Referring professional’s telephone:

Referring professional’s address:

Referring professional’s postcode:

Trust/Hospital/Service:

Has the referrer completed any cognitive testing with the individual: (copy)-YesNo

If you have selected yes, please give details in the box below (tests used, score, etc):

Referring professional’s referral reason and any additional information:

Could you take a short notice appointment?-YesNo

If English is not your first language, do you require an interpreter?-YesNo

Privacy policy *

• I confirm that I have read and I consent to Bridgewater's privacy policy

Submit

Please note: If you want a copy of your referral please save your details before pressing submit. We are unable to send copies of the referral once submitted.

We will use your address to ensure that we are your closest Driving Mobility centre.

If there is a centre closer to you, you will be given the opportunity to select this one.