Get Vt Vs-113 2022-2026

The VT VS-113 form is essential for various medical evaluations related to driving privileges and disability permits in Vermont. This guide provides step-by-step instructions for filling out the form online, ensuring that all necessary information is accurately submitted.

Follow the steps to complete the VT VS-113 form.

1. Press the ‘Get Form’ button to access the VT VS-113 form and open it in your preferred editor.
2. Indicate the reason for the evaluation by selecting one of the options listed at the beginning of the form. Make sure to complete Sections A, B, D, and E if you are applying for a Vermont License, or complete all sections if requesting a disabled placard or plates.
3. In Section A, fill out your personal information, including your name, mailing address, physical address (if different), gender, date of birth, and social security number. If relevant, indicate if there is a name change.
4. Sign to certify that the information you provided is accurate. This signature is required to validate your submission.
5. Section B should be filled out by the medical examiner. Ensure they complete all required fields, including medical history and any applicable conditions of the patient.
6. In Section C, the medical examiner must attest to the applicant's disability status, ensuring one condition is check-marked to confirm eligibility for disabled parking.
7. Section D involves the medical examiner’s opinion on the patient’s driving capabilities. They must check the appropriate statements regarding fitness to drive.
8. Finally, in Section E, the medical examiner should provide their credentials, signature, and contact information. This section is crucial for validation and must be completed by a licensed medical professional.
9. Once all sections are completed and reviewed for accuracy, save your changes, and you can choose to download, print, or share the completed form as needed.

Complete and submit your VT VS-113 form online today.