Get Ct P-142op 2018-2025

The CT P-142OP form is essential for eye care professionals providing a medical report to the Connecticut Department of Motor Vehicles. This guide offers clear instructions for both patients and medical professionals on accurately completing the form online.

Follow the steps to fill out the CT P-142OP online

1. Press the ‘Get Form’ button to access the form and open it in your online editor.
2. Section (A): Patient Information. As the patient, enter your full name, mailing address, operator's license number, date of birth, and phone number. It is important to ensure that all details are accurate.
3. Confirm your understanding by signing the authorization section. Include the date to indicate when you provided your consent for the medical examination.
4. Section (B): Clinical Information and Safety Implications. The eye care professional should fill out this section after a thorough examination. They will indicate if they are your regular eye care provider, document any present eye conditions, and assess your ability to drive safely.
5. The eye care professional should also indicate if a DMV road test is necessary and if periodic reports are needed based on the patient’s condition.
6. Section (C): Eye-Care Specific Information. This section is completed by the eye care professional and includes Visual Acuity (with or without corrective lenses), assessment of monocular vision, and indications of any blind spots.
7. The eye care professional will complete Section (D): Medical Examiner's Certification, certifying that they have examined the patient and that all information is correct. They will include their name, signature, telephone number, and license number.
8. After all sections are filled out, verify that all information is accurate. You can then save changes, download the form, print it, or share it as required.

Complete your CT P-142OP form online for a straightforward submission process.