Depending on your situation (new application, replacement, or renewal), you will need some or all of the following:
New Permanent or Temporary Placard/Plate
- Form 96-0104 completed and signed by an approved medical provider within the last 90 days.
- A valid Arizona driver's license or state-issued ID (or other form of identity).
- Vehicle registration if applying for a disability license plate.
- If applying by mail, include a photocopy of your ID.
Veteran Exemption
- 100% disabled veterans may be eligible for Disabled Veteran license plates.
- You must provide proof of eligibility from the VA. Medical certification may not be required.
Online Doctor’s Certification
If using a telehealth service like ParkingMD:
- You’ll receive a signed and dated Form 96-0104 by email within 24–48 hours.
- You can print and submit it to one of these nearby public ADOT MVD offices or authorized third-party providers.
Mesa/Gilbert Southeast Regional MVD
4123 E. Valley Auto Dr. Mesa, AZ 85206
Apache Junction MVD
575 N. Idaho Road, Suite 600 Apache Junction, AZ 85119
ParkingMD provides the medical evaluation and certification only. Arizona MVD reviews the application and issues the placard.
Lost or Stolen Placard
- Request a replacement through AZ MVD Now or visit an MVD office.
- There is no fee to replace a disability placard.
- Report a stolen license plate to local law enforcement before requesting a replacement plate.