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DR 2219 (06/15/23)
COLORADO DEPARTMENT OF REVENUE
Division of Motor Vehicles
Vehicle Services Section
DMV.Colorado.gov
Parking Privileges Application
Persons With Disabilities must meet one of the
criteria below and have it verified in writing by a
medical professional*:
1. Mobility: Persons who cannot walk two-
hundred feet without stopping to rest.
2. Assisted Mobility: Persons who cannot
walk without the use of, or assistance from,
a brace, cane, crutch, another person,
prosthetic device, wheelchair, or other
assistive device.
3. Respiratory: Persons who are restricted
by lung disease to such an extent that the
person’s forced (respiratory) expiratory
volume for one second when measured by
spirometry is less than one liter, or the arterial
oxygen tension is less than sixty mm/hg on
room air or at rest.
4. Oxygen: Persons who use portable oxygen.
5. Cardiac: Persons who have a cardiac
condition to the extent that the person’s
functional limitations are classified in severity
as class III or IV according to the standards of
the American Heart Association.
6. Other: Persons who are severely limited
in their ability to walk due to an arthritic,
neurological, or orthopedic condition.
* Professional – licensed professionals from
Colorado and bordering states:
• Physician licensed to practice medicine or
practicing medicine pursuant to section 12-
36-106 (3) (i), C.R.S.,
• Commissioned Medical Officer of the
U.S. Armed Forces, the U.S. Public
Health Service, and/or the U.S. Veterans
Administration.
• Advance Practice Nurse registered pursuant
to section 12-38-111.5, C.R.S.
• Physician Assistant licensed pursuant to
section 2-36-107.4, C.R.S.
• Podiatrist licensed under article 32 of
title 12, C.R.S.
• Additional professionals for the Short
Term Placard only.
• Chiropractor licensed under article 32 of
title 12, C.R.S.
• Physical Therapist licensed under article 32 of
title 12, C.R.S.
Impairments are defined as follows:
• Permanent: A condition that is not expected
to change within a person’s lifetime,
given the current state of medical or
adaptive technology.
• Extended: A condition that is not expected to
change within thirty months after the issuance
of an identifying figure, given the current state
of medical or adaptive technology.
• Temporary: A condition that is expected
to last less than thirty months after the
issuance of an identifying plate or placard,
given the current state of medical or
adaptive technology.
• Short Term: A condition that is not
expected to last more than 90 days after the
issuance of a placard.
• Remuneration-exempt disability: A
disability that limits an individual’s: (i) fine
motor control in both hands; (ii) ability to
reach a height of forty-eight inches from the
ground due to lack of strength or mobility
in the individual’s finger, hand, or upper
extremity; or (iii) ability to reach or access a
parking meter due to the use of a wheelchair
or other ambulatory device.
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Options Available:
1. Two sets of license plates (fees apply).
2. One set of license plates (fees apply) and
one permanent (blue) no fee placard and one
remuneration placard.
3. Up to two permanent (blue) no fee placards
and no license plates.
4. One remuneration exempt identifying placard
(May not be issued to a parent or guardian
of a child under 16 years of age) and one
permanent blue placard.
The Department may issue one identifying plate
or placard to each parent or guardian of a child
with a disability who is under sixteen years of
age to be used only when transporting the child.
The Department shall not issue more than two
identifying placards, two identifying plates, or one
plate and one placard for the child Remuneration
cannot be issued to a parent or guardian,
minor, or business.
Applicants with Short Term disabilities qualify for
the following option:
• Two 90-Day no fee Placard (can be renewed
with medical professional’s authorization).
Parking Privileges Application
Medical Professional Certification and Self–Certification
Placard Type Disability Type Medical Professional
Verification
Self-Certification
Three Year Placards (Blue), Three
Year Remuneration-Exempt Placards
(Purple) or Plates: Program recertification
required every three years (by mail or in
person) with completion of DR 2219
Permanent Initially, then every ninth
year (third renewal)
Third and sixth year renewal
by mail with the form DR 2219
signed by a professional, or
in person with a secure and
verifiable identification
Extended Initially, then every third
year with renewal
N/A
Temporary Initially, then every third
year with renewal
N/A
Short Term Placard (Red): Up to two,
only valid until the last day of the month
falling ninety days after the date of
issuance may be renewed only once with
completion of form DR 2219
Short-term Initially, then with 90
day renewal
N/A
Physician Certification Instructions
Notice To Providers
Providers who knowingly misuse or who make false statements to help someone obtain or
retain disabled parking authorization may be fined up to $500,000 for a Class 4 Felony or $1,000
for a Class one misdemeanor, and subject to incarceration.
1. Complete the entire form, sign and date.
2. If you make a mistake on this form, please
complete a new form. Do not write over, white-out
or cross-out information. This will void the form.
3. To sign the form, you must be a Professional
as defined below.
a. Professional: licensed professionals from
Colorado and bordering states:
i. Physician licensed to practice medicine or
practicing medicine pursuant to
section 12-36-106 (3) (i), C.R.S.,
ii. Commissioned Medical Officer of the
U.S. Armed Forces, the U.S. Public
Health Service, and/or the U.S. Veterans
Administration.
iii. Advance Practice Nurse registered
pursuant to section 12-38-111.5, C.R.S.
iv. Physician Assistant licensed pursuant to
section 12-36-107.4, C.R.S.
DR 2219 (06/15/23)
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Physician Certification Instructions
Continued
v. Podiatrist licensed under article 32 of
title 12, C.R.S.
b. Additional professionals for the Short
Term Placard only:
i. Chiropractor licensed under article
32 of title 12, C.R.S.
ii. Physical Therapist licensed under article
32 of title 12, C.R.S.
4. Patients must have a new Professional
verification done as part of their renewal
process depending on the designated
disability (see #5 below). Ensure the Persons
With Disabilities applicant meets one of the
criteria below before you verify in writing:
a. Mobility: Persons who cannot walk two-
hundred feet without stopping to rest.
b. Assisted Mobility: Persons who cannot
walk without the use of, or assistance
from, a brace, cane crutch, another
person, prosthetic device, wheelchair, or
other assistive device.
c. Respiratory: Persons who are restricted
by lung disease to such an extent that the
person’s forced (respiratory) expiratory
volume for one second when measured
by spirometry is less than one liter, or the
arterial oxygen tension is less than sixty
mm/hg on room air or at rest.
d. Oxygen: Persons who use portable oxygen.
e. Cardiac: Persons who have a cardiac
condition to the extent that the person’s
functional limitations are classified in severity
as class III or IV according to the standards
of the American Heart Association.
f. Other: Persons who are severely limited
in their ability to walk due to an arthritic,
neurological, or orthopedic condition.
g. Remuneration-exempt qualifying
disability: See 5e for definition.
5. Applicant must meet one of the impairments
which are defined as follows:
a. Permanent: A condition that is not expected
to change within a person’s lifetime, given
the current state of medical or adaptive
technology.
b. Extended: A condition that is not expected to
change within thirty months after the issuance
of an identifying figure, given the current state
of medical or adaptive technology.
c. Temporary: A condition that is expected
to last less than thirty months after the
issuance of an identifying plate or placard,
given the current state of medical or
adaptive technology.
d. Short Term: A condition that is not expected
to last more than 90 days after the issuance
of a placard.
e. Remuneration-exempt qualifying
disability: A disability that limits an
individual’s:
i. fine motor control in both hands;
ii. ability to reach a height of forty-eight
inches from the ground due to lack of
strength or mobility in the individual’s
finger, hand, or upper extremity;
iii. ability to reach or access a parking meter
due to the use of a wheelchair or other
ambulatory device.
6. Ensure the date reflects the most current
patient information. The condition time is
based on the date you enter (i.e., extended
thirty-months is from the date entered, not the
transaction date).
7. Please do not fax or e-mail the form to the
Division of Motor Vehicles. The applicant must
submit the completed DR 2219 at the time of
registration.
8. You may contact the Title and Registration
Sections at 303-205-5608 with any questions.
DR 2219 (06/15/23)
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Persons With Disabilities Parking Privileges Application
Name of person with disability (please type or print in ink) Date of Birth (MM/DD/YY)
Physical Address
City State ZIP Code
Mailing Address (if different from above)
City State ZIP Code
I certify, under penalty of perjury, that I have read and understand the Persons with Disabilities plate
and placard application and usage requirements and that I am responsible for the use in conformity
with Colorado Revised Statutes 42-3-204 and 42-4-1208. I further understand that violation of
the requirements in the statutes referenced above may result in fines and penalties up to $5,000,
incarceration and community service, and suspension of Persons with Disabilities placards and plates.
Printed name as it appears on identification
Signature of person with disability
Secure and Verifiable ID of:
Applicant Legal Guardian Representative
Type of ID:
Colorado DL Colorado ID Identification document issued
by United States Government
Out of state DL or ID (Only for out of state
residents applying for a short- term placard)
ID Number Expires Date of Birth (
MM/DD/YY)
The undersigned witness affirms that the
Applicant Legal Guardian Entity Representative
Date (
MM/DD/YY)
signing this document presented the identification described above.
Witness Printed Name
Witness Signature
DR 2219 (06/15/23)
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Persons With Disabilities Parking Privileges Application
(continued)
This Section Below Must be Completed by a Professional Defined in Colorado Revised Statute
42-3-204(1)(a), (1)(i) and (i.5)
This Person is Mobility Impaired as Described Below (Check one box) Qualifying criteria are
listed below. All criteria require certification by a person fully licensed to practice medicine in
Colorado or a state that shares a common border with Colorado.
Persons who cannot walk two hundred feet without stopping to rest.
Persons who use portable oxygen.
Persons who cannot walk without the use of, or assistance from, a brace, cane, crutch, another person, prosthetic
device, wheelchair, or other assistive device.
Persons who have a cardiac condition to the extent that the person’s functional limitations are classified in severity as
Class III or Class IV according to standards set by the American Heart Association.
Persons who are restricted by lung disease to such an extent that the person’s forced (respiratory) expiratory volume
for one second when measured by spirometry is less than one liter, or the arterial oxygen tension is less than sixty
mm/hg on room air or at rest.
Persons who are severely limited in their ability to walk due to an arthritic, neurological, or orthopedic condition.
Remuneration-exempt qualifying disability means a disability that limits an individual’s:
i. fine motor control in both hands;
ii. ability to reach a height of forty-eight inches from the ground due to lack of strength or mobility in the individual’s
finger, hand, or upper extremity;
iii. ability to reach or access a parking meter due to the use of a wheelchair or other ambulatory device.
Medical License Number and Issuing State
Name of Professional (please type or print in ink)
Address
City State ZIP Code
I certify, under penalty of perjury, that the above named patient has a physical impairment
complying with 23 CFR 1235. I have read and understand Colorado Revised Statute 42-3-204
and 42-4-1208 as they pertain to certifying persons with disabilities and affirm my knowledge
of the contents of persons with disabilities notices and documentation made available to me
pursuant to 42-3-204(3), C.R.S.
This impairment is:
Permanent*
Extended*
Temporary*
Short Term (will last 90 days or less)
Remuneration- exempt qualifying disability*
*These Placards are valid for and must be renewed every 3 years. (See definitions on the first page).
DR 2219 (06/15/23)
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Persons With Disabilities Parking Privileges Application
(continued)
Impairments are defined as follows:
Permanent–A condition that is not expected to change within a person’s lifetime, given the current
state of medical or adaptive technology.
Extended–A condition that is not expected to change within thirty months after the issuance of an
identifying figure, given the current state of medical or adaptive technology.
Temporary–A condition that is expected to last less than thirty months after the issuance of an
identifying plate or placard, given the current state of medical or adaptive technology.
Short Term–A condition that is not expected to last more than 90 days after the issuance of a placard
(can be renewed with medical professional’s authorization).
Remuneration-exempt disability means a disability that limits an individual’s: (i) fine motor control in
both hands; (ii) ability to reach a height of forty-eight inches from the ground due to lack of strength or
mobility in the individual’s finger, hand, or upper extremity; or (iii) ability to reach or access a parking
meter due to the use of a wheelchair or other ambulatory device.
** Chiropractors and Physical Therapists may only certify a physical impairment for Short Term
Placards Providers who knowingly misuse or who make false statements to help someone
obtain or retain a placard may be fined up to $500,000 for a Class 4 Felony or $1,000 for a Class
one misdemeanor.
Signature of Professional
Phone Number Date (MM/DD/YY)
Name of person with disability or entity representative (please type or print in ink)
DR 2219 (06/15/23)
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Application For Persons With Disabilities Parking Privileges
There is no fee for persons with disabilities placards. Standard registration fees and ownership taxes
will be charged for disability license plates. A plate or placard holder is responsible to safeguard the
plate or placard from use by others.
Please choose one option below: Permanent, Extended, and Temporary Disability
• Submit a completed application in the name of the person with a disability.
• Secure and verifiable identification for the person with a disability.
• Power of Attorney appointing an agent.
• Enclose a photocopy of the title or registration to the vehicle.
Persons with Disabilities with Vehicle (Check one option below)
1 Plate
2 Plates 1 Plate and 1 Placard 1 Placard 2 Placards
1 Plate and 1 Remuneration Placard
1 Placard and 1 Remuneration Placard
Persons with Disabilities without a Vehicle (Check one option below)
1 Placard 2 Placards
1 Placard and 1 Remuneration Placard
Short Term (90-Day) Disability
Short Term Temporary (90-Day) no fee Placard–For persons with a short term disability to the degree described on
page one of this form.
• Submit a completed application in the name of the person with a disability.
• A 90-day temporary placard will be issued which is to be placed inside the vehicle of which the person with a
disability is a passenger.
• The placard is movable from one vehicle to another.
• Out of state applicants can submit their out of state drivers license, identification document or United States
Government identification document.
Signature of person with disability Date (
MM/DD/YY)
DR 2219 (06/15/23)
