Get Missouri Form 1776

Filling out the Missouri Form 1776 is an essential step for individuals seeking disabled person license plates or placards. This guide provides clear instructions to help you complete the form accurately and efficiently online.

Follow the steps to successfully complete the Missouri Form 1776 online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. The first section of the form requires the physician's information. Enter the full name of the physician, select their profession, and provide their license number and state of license.
3. In the patient’s information section, fill in the patient’s name, driver’s license number or date of birth, gender, and street address, including city, state, and zip code.
4. Select the appropriate disabilities applicable from the list provided. At least one disability must be marked to qualify. Ensure you understand the definitions as stated in Section 301.142.1, RSMo.
5. The physician must personally sign the form in the designated area and provide the date of signature. A stamped signature is not acceptable.
6. If applicable, provide an expiration date for temporary disabilities. This date must not exceed 180 days from the date of the statement.
7. Once all sections are completed, review the form for accuracy. Users can then save changes, download, print, or share the form as needed.

Complete your documents online today to ensure timely processing.