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How to use or fill out mv 619 with our platform
- Click ‘Get Form’ to open the mv 619 in the editor.
- Begin by entering the patient's name exactly as it appears on their driver license in the designated fields for Last, First, and Middle Initial.
- Fill in the patient's date of birth using the MM/DD/YY format, followed by their sex selection.
- Complete the patient's street address, including city, state, country, and zip code.
- Input the date of examination in MM/DD/YY format.
- Indicate whether the patient achieved a Snellen Test score of 20/40 or better with one or both eyes by selecting 'YES' or 'NO'.
- Specify if corrective lenses were worn during the test by selecting 'YES' or 'NO'. If 'NO', note that form MV-80L must be completed.
- Enter the name and title of the provider completing this report along with their street address and city/state/country details.
- Select how long this report is valid for: either 12 months or 6 months from the examination date.
- Finally, ensure that the provider signs in full and includes their professional license number before saving your document.
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