Get Ct P-142r 2017-2026

The CT P-142R is a medical report utilized by the Connecticut Department of Motor Vehicles to assess a person's ability to safely operate a motor vehicle based on their respiratory health. Completing this form accurately is essential for ensuring the driver's fitness to drive, and this guide will provide you with step-by-step instructions to fill it out online effectively.

Follow the steps to complete the CT P-142R online.

1. Click the ‘Get Form’ button to access the CT P-142R form and open it in the editor.
2. Begin by entering the driver's license number in the designated field. Ensure that this number is accurate as it links the medical report to the individual's driving records.
3. Fill out the patient’s personal information, including their name, address, date of birth, and telephone number. Make sure to use clear and correct details.
4. Indicate the duration of your treatment for the patient in the appropriate field, which helps establish your familiarity with their health condition.
5. Record the date of the last examination performed on the patient. This should be within 90 days before filing the form.
6. In the section regarding any abnormalities on the respiratory examination, check any conditions that apply, such as asthma, chronic obstructive pulmonary disease (COPD), or sleep apnea. Provide explanations as needed.
7. Answer the questions regarding the progressiveness of the illness and any special aids or devices required while operating a vehicle. Be clear in your responses.
8. Confirm the patient's ability to exhale 1000cc of air during the operation of an ignition interlock device. This is essential for assessing their respiratory capability while driving.
9. Evaluate if the patient understands the risks posed by their condition and if they are taking medications as prescribed. Your professional opinion here is crucial.
10. If there are any other conditions that should be evaluated by another specialist, mention them. If no other conditions apply, indicate if the individual requires restrictions to operate a motor vehicle.
11. Provide your certification as a medical professional. Sign and include your name, license number, specialty, office address, and the date the report was completed.
12. Finally, review all entered information for accuracy. Once verified, save the changes, download a copy of the form, or print it as necessary.

Complete your documents online today to ensure all requirements are met efficiently.