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Get Form Med4 "customer Vision Report" - Virginia - Templateroller
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How to fill out the Form MED4 'Customer Vision Report' - Virginia - TemplateRoller online
Filling out the Form MED4 'Customer Vision Report' is essential for requesting vision examination information required for safe driving in Virginia. This guide will provide you with step-by-step instructions to successfully complete the form online.
Follow the steps to complete the form accurately and efficiently.
- Click ‘Get Form’ button to obtain the form and open it for editing.
- Begin with the Customer Information section, where you will fill out your name, customer number (from your driver license or SSN), residential address, birthdate, city, state, zip code, daytime telephone number, and mailing address if it differs.
- Once you have completed your section, provide the form to your ophthalmologist or optometrist who will fill out the Vision Examination section, which includes examination dates and any visual/ocular conditions affecting driving.
- Ensure your provider records all required visual measurements, including uncorrected and best corrected visual acuity for both eyes and necessary comments.
- After all sections are completed, review the form for accuracy, then proceed to save your changes, download, print, or share the completed document as needed.
Complete your Form MED4 online today for a smoother driving experience.
What You'll Need to Renew your Virginia Driver License Social Security Number. Date of birth. Current driver's license. $32 for Class D driver's license renewal fee. $10 fee if you'll upgrade the license to REAL ID. Vision Test (if applicable)
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