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  • Ct P-142c 2017

Get Ct P-142c 2017-2025

Rred to the DMV Driver Services Division concerning their ability to operate a motor vehicle safely. This medical report must reflect the results of the licensed physician's personal examination of the patient performed within 90 days of this report being filed. It must be signed by the patient authorizing the physician to release this report and any attachments to DMV. I hereby authorize the licensed physician completing and signing this medical report to release such report to DMV along with.

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How to fill out the CT P-142C online

The CT P-142C is a cardiology medical report required by the Connecticut Department of Motor Vehicles. This guide will provide clear, step-by-step instructions for completing the form online to ensure it meets all necessary criteria.

Follow the steps to properly complete the CT P-142C form.

  1. Click ‘Get Form’ button to access the CT P-142C and open it in your online document editor.
  2. Begin by entering the patient's driver's license number at the top of the form. This identifies the individual who is the subject of the medical report.
  3. The patient must sign the authorization statement, confirming that they allow the physician to release the medical report to the DMV.
  4. List any conditions relevant to the safe operation of a motor vehicle. Be specific about medical issues that may affect the patient's driving ability.
  5. State if the patient has experienced any altered circulatory stability and any medications that are relevant to their ability to operate a vehicle, including doses.
  6. The physician must answer questions about the patient's understanding of their condition, adherence to medication, and any concerns regarding substance abuse.
  7. Complete any additional comments or notes that may be relevant to the patient's condition or driving ability.
  8. The physician must certify the report by signing, printing their name, and providing their license number and specialty. Include the date the report is completed.

Complete your CT P-142C online today to ensure a smooth reporting process.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232