Professional Documents
Culture Documents
Last name/family name, first name/given name, middle name Norwegian national ID no. (11 digits)
Issued by (country)
Do you have a driving licence issued by another country?
If “yes”, please enter additional information in the fields
Driving licence category/-ies Issue date Expiry date
provided. Yes No
Complete if the application is for the Revoked by police district in Norway / authority in another country Revoked from (date) Revoked until (date)
return of a revoked driving licence.
Personal Health Statement – see the reverse side of this form for information
Read the questions below thoroughly before answering them and signing the application form.
Yes No
1. Do you have reduced vision and require glasses or contact lenses?
2. Have you experienced double vision during the last three months, or problems driving in the dark or
in fluctuating light, or do you have reduced peripheral vision in one or both eyes?
3. Do you have difficulties with traffic orientation or in making correct traffic assessments?
4. Do you suffer from, or have you in the past suffered from, any form of neurological disorder or disease?
5. Have you experienced fainting, seizures/spasms or any other episodes of reduced consciousness during
the last five years?
6. Have you experienced fainting, seizures/spasms or any other episodes of reduced consciousness
during the last ten years, or have you used medication for epilepsy during the same period of time?
7. Do you suffer from obstructive sleep apnea or any other sleep disease?
8. Do you suffer from, or have you in the past suffered from, cardiovascular disease?
9. Do you suffer from diabetes?
10. Do you suffer from or have you in the past suffered from, a serious mental disorder, or do you have
a mental condition that may affect your ability to drive?
11. Do you suffer from ADHD?
12. Do you use any medications that may affect your driving?
13. Do you abuse alcohol or other intoxicating substances, or have you done so over the last three years?
14. Do you suffer from reduced lung capacity?
15. Do you suffer from, or have you in the past suffered from, serious kidney failure?
16. Do you have reduced mobility of arms or legs?
17. Do you have any other health issues that may affect your ability to drive?
I am aware that withholding information or giving false information is a punishable offence. If a health certificate is required,
I will authorise my medical doctor to obtain the necessary and relevant information from medical specialists and my previous
GP(s) regardless of professional secrecy, in order to ensure a safe and correct assessment. If I experience long-term changes to
my health that may interfere with my driving, I am obligated to see a medical doctor before I continue to drive.
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .........................................................
Place and date Applicant’s signature
Blankett NA-0201 engelsk 2017
When is a Health Certificate required?
This is related to your answers to questions 1-7 in the Personal Health Statement on page 1 of this application form.
Heavy vehicle categories and Certificates of Professional Competence for drivers of emergency
vehicles
For licence categories C1, C1E, C, CE, D1, D1E, D, DE and for Certificates of Professional Competence for emergency vehicles, a Health
Certificate (Helseattest førerett) is always required when driving entitlements and renewals are applied for.
General provisions
The Health Certificate (Helseattest førerett) / Eyesight Certificate (Helseattest førerett – syn) must not be more than three months old
when it is submitted to the Driver and Vehicle Licensing Office (trafikkstasjon).
The Health Certificate and, if applicable, an Eyesight Certificate must be submitted in such cases as required by the police, health
authorities or road authorities in order to assess whether an individual has illness or health issues of relevance for traffic safety.
A Health Certificate is also required when you apply for renewal of a driving license with a health-related expiry date. A Health
Certificate is always required when you apply for renewal of your driving licence after you have turned 75.
In certain cases the doctor may request that a driving assessment be carried out in order to determine whether your health issues
affect your ability to drive a vehicle. More information about such driving assessments is available in Norwegian in the document
Førerkortveileder (Driving licence guide), at www.helsedirektoratet.no.
General information
ID: You must present a valid ID with your name, Norwegian national ID number (11 digits) and a photo in order to take
the theory test and the practical driving test, and also before your driving licence or Certificate of Professional
Competence is issued.
Photo: A photo will be taken at the Driver and Vehicle Licensing Office (trafikkstasjon), unless your photo already has
been stored electronically.
Fee: A fee must be paid before each theory test and practical driving test, before the issuing of a driving licence or
Certificate of Professional Competence, as well as for a new photo and a new signature.
Training: The driving school, the training institution or the training provider must report to the Norwegian Public Roads
Administration that you have completed the mandatory driving. This must be reported no later than three days
before the practical test. For Certificates of Professional Competence, the training must be reported before the
theory test.
Storage of data: The Norwegian Public Roads Administration (NPRA) is required to keep records of matters related to driving licences.
Personal data and information regarding your driving entitlements and licenses are registered and may be used by
the NPRA, the police and Norwegian Customs. Information of a non-confidential nature may be released to third
parties in accordance with the Freedom of Information Act.
Further information on driving licences and health requirements may be found in the Regulations relating to driving
licences, etc. – Forskrift om førerkort m.m - at www.lovdata.no (Norwegian only) and www.vegvesen.no. The latter
website also provides information on how to contact the NPRA.