Get Report Of Eye Examination - Media.dojmt.gov

Filling out the Report of Eye Examination is a crucial step for individuals seeking to provide their vision assessment to the Motor Vehicle Division. This guide offers clear instructions on how to complete the form accurately and efficiently online.

Follow the steps to complete your eye examination report online.

1. Press the ‘Get Form’ button to access the Report of Eye Examination and open it in your editor of choice.
2. Begin by filling in the driver’s legal name in the designated field at the top of the form. Ensure that the name matches the identification documents.
3. Provide the driver license number in the specified section to accurately link the report with the driver's record.
4. Enter the driver’s mailing address, city, state, and zip code, ensuring the information is correct for future communications.
5. Record the driver's birth date in the format mm/dd/yyyy, paying attention to the correct spacing and punctuation.
6. Fill in the daytime phone number for any necessary follow-ups or clarifications required by the Motor Vehicle Division.
7. In the 'Record of Examination' section, carefully document the visual acuity measurements for both eyes and together. Fill in values for distant vision both with and without glasses, as well as the best possible correction.
8. Complete the breadth of vision field measurements to the right and left of the point of fixation, noting the total angle as applicable.
9. Indicate whether double vision is present and if condition can be corrected with treatment by checking 'Yes' or 'No' as appropriate.
10. Sign the release of information section in the presence of the eye specialist to authorize them to share necessary information with the Motor Vehicle Division.
11. Have the eye specialist complete their section, including their signature, printed name, date, type of practice, address, telephone number, and medical license number.
12. Once all sections are complete, save any changes made to the document. You can then download, print, or share the completed form as needed.

Complete your Report of Eye Examination online today for a smooth processing experience.