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Mva vision form 2026

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The document is a Vision Form used to record the results of vision screenings and examinations for patients seeking to obtain or maintain a driver's license. It includes sections for documenting visual acuity with and without corrective lenses, field of vision, color vision problems, and recommendations from a vision specialist regarding the patient's ability to drive safely. The form also requires certification from a licensed physician.

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Click ‘Get Form’ to open the MVA Vision Form in the editor.
Begin by entering the DRIVER/PATIENT’S FULL NAME and MARYLAND DRIVER’S LICENSE NUMBER at the top of the form.
In the section regarding corrective lenses, indicate whether they improve the patient’s vision for driving by selecting YES or NO.
Fill in the ACUITY WITHOUT LENSES and ACUITY WITH PRESENT LENSES for both right and left eyes, as well as for both eyes combined.
Complete the FIELD OF VISION section by providing degrees for each eye. Ensure to answer questions about continuous field of vision and color vision problems.
The vision specialist should sign and date the form, certifying that all information is accurate. Include their printed name and contact details.

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