HMSA Medical Form

HMSA requires a medical form to be on file before a member can participate in any HMSA event.

The form must be filled out and signed by your doctor, and the original returned to HMSA. If you are under 50 years of age HMSA accepts VMC approved forms from other vintage clubs as well as SCCA and FIA medical forms. If you are over 50 years we will only accept the HMSA form. The HMSA form asks specific questions that are not answered on other forms.

All drivers are required to have completed a specified medical examination once every two years if under 60 years old and every 14 months if 60 and older. Examinations and medical cards for drivers who have not reached their 58th birthday will expire two years from the date of examination. For drivers 58 and over, examinations and medical cards will expire upon the driver’s 60th birthday or one year from the date of examination whichever is longer. Medical cards will be issued upon receipt of your completed original physical form.

Any change in your physical condition or medical history invalidates your card and must be reported by letter to the HMSA office before entry in any race event.

Download a printable PDF Medical Form
Just print it, fill it out and send it back to the HMSA office.

Mailing Address:
2029 Verdugo Blvd., #1010
Montrose, CA 91020