If a physician determines that a patient's epilepsy severely impairs the ability to safely operate a motor vehicle, the physician shall sign a written statement verifying that the physician informed the patient and provide a copy of the signed statement to the patient and to the DMV. (Note: State Board of Health defines this reportable as any person aged 14 or older who during the preceding three years has experienced on one or more occasions either a lapse of consciousness or an episode of marked confusion caused by any condition which may bring about recurrent lapses, [...] including but not limited to epilepsy, senility, diabetes mellitus, cardiovascular disease, alcoholism or excessive use of alcohol sufficient to bring about blackouts.)