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  • Med 4 (08/25/2010) Customer Vision Report Purpose: Use This Form To Request Vision Examination

Get Med 4 (08/25/2010) Customer Vision Report Purpose: Use This Form To Request Vision Examination

MED 4 (08/25/2014) CUSTOMER VISION REPORT Purpose: Use this form to request vision examination information from your ophthalmologist or optometrist. Instructions: Complete the Customer Information.

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Visual acuity refers to the sharpness of vision at 20 feet from an object. A person with 20/50 vision can clearly see something 20 feet away that a person with normal vision can see clearly from a distance of 50 feet. Bad distance vision was considered "improved" if corrections boosted visual acuity to 20/40 or better.

The numbers in your visual acuity measurement have to do with distance. It might be easiest to explain if you imagine the Snellen chart: When you have a Snellen test score of 20/40, that means you'd see the chart as clearly at 20 feet away as someone with “normal” vision would see it from 40 feet away.

The third line is equivalent to 20/40, it is the driver's test line.

20/40 or better vision, corrected or uncorrected. 120 degrees horizontal vision.

For example, if your vision is 20/20, it means that from 20 feet away, you can see the smallest letters that should be seen at 20 feet. If your vision is 20/60, this means that from 20 feet away you can only see letters that would normally be visible at 60 feet.

If you fail the vision test while wearing your eyeglasses or contacts, your prescription could be outdated. In that case, you'll need to schedule a comprehensive eye exam, where an eye doctor can measure your eyesight and provide an updated prescription for glasses or contacts.

A person with 20/40 vision sees things at 20 feet that most people who don't need vision correction can see at 40 feet. This means that they are nearsighted, but only slightly. A person with 20/40 vision may or may not need eyeglasses or contacts, and can discuss his or her options with a doctor.

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.

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© Copyright 1997-2025
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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