Vehicle modifications are often essential to ensure that drivers with disabilities can drive independently and safely. Occupational therapy driver assessors and driver rehabilitation specialists routinely prescribe vehicle modifications on the basis of individualized evaluations and support by rehabilitation interventions. After a literature review and consultation with stakeholders, we identified a resource gap in information to support an evidence-based process for vehicle modification prescription. Using an action research approach, we established content validity for draft guideline items and developed consensus-based draft guidelines for vehicle modification prescription that are ready for trialing by occupational therapy driver assessors. We also propose a practice model for vehicle modification prescription that is applicable to international contexts.