Article 11 — Compliance with the minimum standards of physical and mental fitness

1. Member States shall, before a driving licence is issued for the first time, ensure that applicants undergo a medical examination in which the minimum standards of physical and mental fitness covering all the medical conditions set out in Annex III are applied. That applies to the issuance of driving licences in category AM only if so required by the Member State in question in accordance with Article 10(1), point (b). A medical examination shall, however, be required in respect of applications for driving licences of categories C, CE, C1, C1E, D, D1, DE or D1E, regardless of whether a medical examination was undertaken for another category. 2. Before a driving licence is renewed, applicants for the renewal shall undergo a medical examination covering the medical conditions set out in Annex III. This shall apply to the renewal of driving licences in category AM only if so required by the Member State in question in accordance with Article 10(1), point (b). 3. Notwithstanding paragraphs 1 and 2, and to the extent not otherwise provided for by Annex III, such as in the case of the appropriate assessment of eyesight for applicants for driving licences in accordance with Annex III, point 3, Member States may, for categories AM, A, A1, A2, B, B1 and BE, instead of requiring a medical examination, apply one or both of the following alternative measures: (a) require the applicant or holder of the driving licence to fill in a self-assessment form covering the medical conditions set out in Annex III when applying for the issuance or renewal of a driving licence; or (b) establish a national system of assessment of fitness to drive to ensure that significant changes in physical or mental fitness are reacted to in order to comply with the minimum standards of physical and mental fitness set out in Annex III, after the driving licence has been issued to the applicant following a medical examination or self-assessment. 4. Member States may provide for appropriate measures to address non-compliance with the requirement to fill in a self-assessment form or for knowingly providing information in the self-assessment form that is incorrect or incomplete, or for failing to meet any requirement established in accordance with paragraph 3, point (b). 5. Member States may apply the alternative measure under paragraph 3, point (b), in such a way that it allows the monitoring of fitness to drive during periods of administrative validity. 6. If, on the basis of information acquired pursuant to the various alternative measures set out in paragraph 3, it becomes apparent that the applicant or holder of a driving licence is likely to have one or more of the medical conditions listed in Annex III, Member States shall ensure that the applicant or holder of the driving licence undergoes a medical examination prior to the Member States issuing or renewing the driving licence. 7. This Article shall not prevent Member States from taking measures to raise awareness and improve the knowledge of the health sector and of driving licence holders about the minimum standards of physical and mental fitness for driving set out in Annex III. If Member States adopt guidelines for medical practitioners to help identify driving licence holders who no longer meet the minimum standards of physical and mental fitness to drive, they shall inform the Commission thereof. The Commission shall make the guidelines available to the other Member States. If Member States develop public awareness campaigns to inform citizens about mental or physical health conditions that may impair fitness to drive, they shall inform the Commission thereof. The Commission shall make the information available to the other Member States. 8. The standards set by Member States for the issuance or any subsequent renewal of driving licences may be stricter than those set out in Annex III.