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Get Ct Dmv P-142m 2020-2026

MEDICAL FORMSTATE OF CONNECTICUT DEPARTMENT OF MOTOR VEHICLES 60 STATE STREET, WETHERSFIELD, CT 061611013 DRIVER SERVICES DIVISION ct.gov/dmvP142M Rev. 220Department of Aging and Disability Services.

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How to fill out the CT DMV P-142M online

Completing the CT DMV P-142M form online is an essential step for individuals undergoing medical evaluations related to their driving capabilities. This guide provides clear instructions for each section of the form, ensuring a smooth process for both patients and medical examiners.

Follow the steps to complete the form online effectively.

  1. Press the ‘Get Form’ button to access the CT DMV P-142M and open it in your preferred digital format.
  2. In Section (A), provide your personal information. Fill in your name, mailing address, date of birth, operator's license number, and phone number. Ensure accuracy in this section as it identifies you directly.
  3. Sign the authorization statement at the bottom of Section (A). This allows your medical examiner to conduct the necessary evaluation and report to the DMV.
  4. Section (B) is reserved for your medical examiner. Ensure they complete this section after performing your examination. They will indicate any conditions impacting your ability to drive and whether periodic reports should be submitted.
  5. Review any conditions noted in Section (B) that may require additional information or special equipment for driving. Your examiner will confirm if you need to complete a DMV road test.
  6. Proceed to Section (C). This section includes various specialties such as cardiology and neurology. Your medical examiner must indicate any known conditions and specific details relevant to your medical history.
  7. Once all sections are completed, confirm that all information is correct. Ensure your medical examiner has signed and filled out their details, including name, license number, and specialty.
  8. After reviewing the entire form, you may choose to save the changes, download the completed form, print it for records, or share it as necessary.

Complete your CT DMV P-142M online to ensure a streamlined process in managing your driving fitness evaluations.

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Related content

DMV Medical Form P-142M - CT.gov
P-142M Rev. 7-18. This patient has been referred to the DMV concerning his or her ability...
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