What the TRANS3050 is for
Alberta uses National Safety Code Standard 6, Determining Driver Fitness in Canada, to decide whether drivers are medically fit, and the TRANS3050 is the general medical assessment most drivers with exam requirements must provide. You report findings against the standards on the back of the form. Alberta makes the licensing decision, which can mean no conditions, a condition code, a lower class or a suspension. Commercial drivers with epilepsy or monocular vision may get a code W, which allows driving in Canada but not in the United States. A report about a patient you think is unsafe is a separate process from this routine medical.
Who completes it
Any Canadian-licensed physician or nurse practitioner completes Part A, the medical history and physical examination, and Part B, the practitioner’s statement and certificate. The applicant signs Part C, the operator’s certificate and waiver, which confirms that what they told you is true and authorizes release of the information to Alberta Transportation. Part D is for government use.
How to fill in Parts A and B
Visual acuity and hearing
Record uncorrected and corrected acuity for each eye and both eyes. The standards differ by class: 6/9 with both eyes for classes 1 to 4 (emergency), 6/12 for taxi and commercial class 5, and 6/15 for classes 5, 6 and 7. Hearing applies only to bus, taxi, ambulance and dangerous goods drivers, with a loss over 40 decibels averaged at 500, 1000 and 2000 Hz as the threshold. If you can’t test visual fields or hearing in the office, mark Ref for an optometrist or audiologist.
Medical conditions
Work through the cardiovascular, nervous system, respiratory, metabolic, psychiatric and other sections. A Yes means the applicant doesn’t meet the standard and is ineligible for that class at the time of application. A Ref means Alberta will ask for a specialist, optometrist or audiologist report. For diabetes, give the onset, type of control and the date of the last significant hypoglycemic episode. For seizures, give onset, last seizure and frequency. Record blood pressure and any past myocardial infarction with an approximate date.
Cognition
Mild dementia or memory dysfunction points to a road test. Moderate to severe dementia is a disqualifying Yes. Use the screening tools you think fit, and say in the record which ones you used.
Practitioner’s statement and certificate
Say whether you are the applicant’s regular physician or nurse practitioner and for how long, whether you recommend a driver’s examination, and which licence classes the applicant meets. Print your name and address, sign and date the examination.
Common reasons it’s delayed or returned
- Classes left blank in the practitioner’s certificate.
- A Ref with no indication of what specialist information is needed.
- Missing diabetes or seizure dates.
- The applicant’s waiver in Part C unsigned.
- A report more than six months old by the time it reaches the registry.
Submitting and who pays
The driver submits the completed form, and a registry agent or Driver Fitness and Monitoring records the outcome in Part D. Alberta says processing can take up to eight weeks. The exam isn’t insured under AHCIP, so the driver pays. You must quote the fee before you start, and CPSA standards require it to reflect your costs and the patient’s ability to pay.