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One Canadian province now requires occupational therapists (OTs) to report medically at-risk drivers to the transportation authority. This study examined OTs' legal and professional responsibilities with regard to medical fitness to drive. Two knowledge translation models guided the study design. Semi-structured interviews were conducted with 7 OTs, a geriatrician, as well as representatives from professional regulatory organizations and the licensing bureau. Emergent themes highlight gaps in the translation of knowledge specific to professional responsibilities as well as ethical risks to client rapport. Further education on relevant policies is suggested and changes to existing resources that support clinical practice.