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DVLA D4 Driver Medical Request Form

Appointment type

In-person appointment

In-person appointment in Cambridge (CB24 8TX)

D4 medical in Cambridge£39.99

Home visit

Please select the band that best matches your location

Home visit up to 10 miles from CB24 8TX£49

Home visit 11-25 miles from CB24 8TX£55

Home visit 26-50 miles from CB24 8TX£65

Home visit 51-75 miles from CB24 8TX£75

Home visit 76-100 miles from CB24 8TX£85

Personal details

Full Name

Date of Birth

Day

Month

Year

Home Address

Postcode

Telephone Number

License details

Type of licence

Is this your first Group 2 medical?

Medical screening

Are you aware of any medical condition that may affect DVLA fitness to drive?

Medical condition

Add anything you feel we should be aware of or any questions you have

Preferred timing

Preferred date and time (subject to availability)

February 2026

Week starting Sunday, February 1

Time zone: Coordinated Universal Time (UTC)TBC

Thursday, Feb 5

10:00 AM - 11:00 AM

11:00 AM - 12:00 PM

12:00 PM - 1:00 PM

1:00 PM - 2:00 PM

Please let us know your preferred date. This is a preference only and we will confirm availability and get back to you promptly.

Do you already have a DVLA D4 form?

Yes, I will bring it

You can download the D4 form from the DVLA website, or we can provide it.

I confirm the information provided is accurate to the best of my knowledge

I understand this is a private medical service

I understand home-visit pricing is based on distance band from CB24 8TX

I understand DVLA acceptance is subject to their own criteria

I confirm that I have read and understood the Clarity Medicine Terms of Service, Disclaimer, and Privacy Policy, and I agree to proceed on this basis.

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Clarity Medicine

GMC-registered doctor-led medical services