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Massachusetts Impaired Driving ProgramFEE WAIVER FORM This form is to be used only for courtapproved 24D program waivers. COURT OFFICERS: Please complete this form in its entirety. Print legibly and

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How to fill out contact dph impaired driving

01

Obtain the contact information for the Department of Public Health (DPH) impaired driving division.

02

Fill out the required fields with accurate and detailed information about the impaired driving incident.

03

Submit the completed form to the designated DPH impaired driving contact.

Who needs contact dph impaired driving?

01

Individuals who have been involved in or witnessed an impaired driving incident and need to report it to the Department of Public Health.

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What is contact dph impaired driving?

Contact DPH impaired driving is a form that must be filed to report incidents of impaired driving to the Department of Public Health.

Who is required to file contact dph impaired driving?

Any individual or organization involved in an incident of impaired driving is required to file contact DPH impaired driving.

How to fill out contact dph impaired driving?

Contact DPH impaired driving can be filled out online through the Department of Public Health's website or submitted via mail.

What is the purpose of contact dph impaired driving?

The purpose of contact DPH impaired driving is to track and monitor incidents of impaired driving for statistical and enforcement purposes.

What information must be reported on contact dph impaired driving?

Information such as date, time, location, individuals involved, and any other relevant details must be reported on contact DPH impaired driving.

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