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Dor. mo. gov FORM VISION EXAMINATION RECORD REV. 05-2013 PATIENT NAME LAST FIRST MIDDLE DRIVER OR PATIENT SECTION SOCIAL SECURITY NUMBER DATE OF BIRTH MM/DD/YYYY - - / / PATIENT MAILING ADDRESS CITY STATE ZIP CODE I hereby authorize and accept that My physician will conduct an eye examination to determine if my visual abilities are adequate to operate a motor vehicle safely and responsibly. MISSOURI DEPARTMENT OF REVENUE DRIVER LICENSE BUREAU P. O. BOX 200 TELEPHONE 573 751-2730 301 WEST HIGH STREET ROOM 470 FAX 573 522-8174 JEFFERSON CITY MO 65105-0200 WEB SITE www. The Driver License Bureau will make a final decision concerning my eligibility for driver licensure based on all available information* Signature of Driver or Patient must be signed in the presence of physician Date MM/DD/YYYY / / Yes Distance Acuity No Are you a regular or primary eye care provider for this patient PHYSICIAN If yes how many times have you seen this patient in the past year If no are you evaluating this pa....

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New Mexico standards for vision are 20/40 or better in at least one eye, with or without glasses. If the customer is not able to pass the vision test in the MVD field office, provide the customer with the Vision Report form (MVD-10125) to be completed by their ophthalmologist or optometrist and returned to the MVD.

NOTE: An applicant for driver license renewal is required to take a road sign recognition test and vision test.

To renew your driver license or nondriver ID, you must present acceptable documents to verify the following: Proof of Identity; Date of Lawful Status; Proof of Social Security number; and. Proof of Missouri residential address.

Vision Referral You will be given a Report of Vision Examination (DL 62) form for your eye doctor to complete and sign. When you return to the DMV with the DL 62 form, your vision will be retested. You will also have to take a driving test to demonstrate that you can drive safely, even though your vision is impaired.

DMV's Screening Standards Anyone who applies for an original or renewal driver license must meet the department's visual acuity (vision) screening standard. The DMV's vision screening standard is: 20/40 with both eyes tested together, and. 20/40 in one eye and at least, 20/70 in the other eye.

The test is NOT an open book test. minimum peripheral reading is at least 55 degrees in each eye or 85 degrees in one eye. If you are unable to meet the vision standards as required, you may be denied a license, or restrictions may be placed on your license.

Acuity readings through the carrier lenses must be 20/100 or better in both eyes. Acuity readings through the lenses must be 20/40 or better in both eyes. Peripheral readings must be 140 degrees binocular or 70 degrees temporal and 35 degrees nasal monocular.

You'll need to pass a vision test to get your license. You need to have 20/60 vision in each eye with or without correction. If you are blind in one eye, the other eye needs 20/50 vision with or without correction. You also need to have 70 degrees of vision in the horizontal meridian between both eyes.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232