Vt vs 113 medical evaluation report form 2026

1. Click ‘Get Form’ to open the vt vs 113 medical evaluation report form in the editor.
2. Begin by completing Section A, where you will provide your personal information including your name, mailing address, date of birth, and social security number. Ensure all details are accurate.
3. Indicate the reason for evaluation by checking one of the options provided. If applying for a disabled placard or plates, complete all sections as required.
4. Sections B, C, D & E must be filled out by a medical examiner. Ensure they check any applicable conditions and provide their professional opinion regarding your fitness to drive.
5. Finally, have the medical examiner sign and date the form in Section E. This section must be completed by a licensed physician or authorized medical professional.

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