Get Visual Exam Dld Utah Form

Completing the Visual Exam Dld Utah Form online is a straightforward process that ensures your application is submitted accurately. This guide will walk you through each step, providing clear instructions to help you fill out the form efficiently.

Follow the steps to complete the Visual Exam Dld Utah Form correctly.

1. Click ‘Get Form’ button to download the form and access it in an online editing platform.
2. Begin by filling out the top portion with your personal information. Include your last name, first name, middle or maiden name, date of birth, and your Driver License or driving privilege card number.
3. Enter your address, which should include the street address, city, state, and zip code. If your address differs from that on your Driver License or driving privilege card, make sure to check the provided box.
4. Add your Social Security Number or ITIN to the designated field.
5. Read the authorization statement carefully. Understand that by signing this form, you permit healthcare professionals to disclose relevant health information to the Utah Driver License Division.
6. Sign and date the application in the designated area. Remember that the form will not be processed without your signature.
7. Complete the 'Visual Acuity' section as required. Specify your vision for each eye as well as both eyes, indicating if lenses are necessary while driving.
8. Fill out the 'Visual Field’ section, noting any required restrictions, such as driving conditions.
9. Ensure that a healthcare professional completes the 'Visual Acuity Report.' This section will include their printed name, signature, degree, state license number, and contact information.
10. Review the entire form for accuracy, then save your changes. You can download, print, or share the completed form according to your needs.

Encourage users to complete their documents online for a smoother process.