Submit vision test to dmv 2026

1. Click ‘Get Form’ to open the submit vision test report in the editor.
2. Begin by entering the patient's last name, first name, and middle initial in the designated fields.
3. Input the date of birth using the format Mo./Day/Yr. and select the patient's sex.
4. Fill in the patient's address, including street number, city, state, and zip code.
5. Record the date of examination and ensure to enter the best vision test score for each eye as applicable.
6. Indicate whether corrective lenses were used by selecting 'YES' or 'NO'.
7. Have the patient sign their full name in box number 8.
8. The provider must complete their information in boxes 9 through 12, including signature and license number.

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