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  • Ct P-142p/s 2017

Get Ct P-142p/s 2017-2026

PSYCHIATRIC/SUBSTANCE ABUSE MEDICAL REPORTSTATE OF CONNECTICUTDRIVER 'S LICENSE NUMBERDEPARTMENT OF MOTOR VEHICLES DRIVER SERVICES DIVISION ct.gov/dmvP142P/S REV. 82017YESCDL/PSNOMAIL TO: DMV, Driver.

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How to fill out the CT P-142P/S online

Filling out the CT P-142P/S form is a crucial step in determining the ability of a person to operate a motor vehicle safely. This guide provides clear, step-by-step instructions for completing the form online, ensuring that all necessary information is accurately captured.

Follow the steps to complete your CT P-142P/S form online.

  1. Press the ‘Get Form’ button to access the CT P-142P/S document and open it in the designated online editor.
  2. Begin by entering the driver's license number in the appropriate field to identify the patient.
  3. Fill out the personal information section, including the patient’s name, date of birth, telephone number, address, and zip code. Ensure all entries are accurate and complete.
  4. Document the date of the last examination performed by a licensed physician.
  5. Indicate the category of medications the patient is currently taking by checking all applicable boxes.
  6. For each medication relevant to motor vehicle operation, provide the name and dose in the specified fields.
  7. Answer the questions regarding the patient’s medical history accurately, indicating whether the patient currently suffers from convulsive seizures and the date of the last episode, if applicable.
  8. Respond to the questions regarding the patient’s understanding of their condition, medication adherence, and any suspicion of substance abuse.
  9. If appropriate, indicate whether the patient requires periodic medical reporting, and specify any relevant conditions along with recommended monitoring intervals.
  10. Provide any additional details that should be evaluated by another specialist if necessary.
  11. Conclude by answering whether the patient can safely operate a vehicle and whether road testing or special equipment evaluations are recommended.
  12. The physician must sign and date the report, certifying the accuracy of the information provided.
  13. After completing the form, save your changes, and utilize the available options to download, print, or share the completed document.

Complete your CT P-142P/S form online today to ensure a smooth and efficient processing of your medical report.

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