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Why did i get a functional ability evaluation medical report utah

FUNCTIONAL ABILITY EVALUATION MEDICAL REPORT UTAH - publicsafety utah 2025

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The document is a Functional Ability Evaluation Medical Report required by the Utah Driver License Division. It collects personal information from applicants regarding their physical, mental, and emotional health that may affect their ability to drive. The report includes sections for healthcare professionals to assess and indicate the applicant's functional ability across various medical conditions, such as diabetes, cardiovascular issues, neurological conditions, and more. It also outlines the authorization for healthcare professionals to disclose relevant health information and emphasizes the importance of completing the form accurately for processing driving privileges.

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Begin by clicking ‘Get Form’ to open the FUNCTIONAL ABILITY EVALUATION MEDICAL REPORT in our editor.
In the top portion, complete your personal information using black ink. This includes your last name, first name, middle or maiden name, date of birth, and driver license number.
If applicable, indicate any changes to your residential or mailing address as instructed. Ensure you follow the guidelines for updating your address on the Utah Driver License website.
In the health section, report any medical conditions that may affect your driving ability. Be thorough and include details about medications and any relevant health history.
Sign and date the form at the bottom of the applicant's section. Remember that without a signature, processing will not occur.
For the Health Care Professional Report section, ensure that a qualified healthcare professional completes their part accurately, including their signature and contact information.

Start filling out your FUNCTIONAL ABILITY EVALUATION MEDICAL REPORT today using our platform for free!

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What does a review examination in Utah potentially include for a driver?

Utah Department of Public Safety Which could include: The driver may be required to complete a driver review which includes a written knowledge test, a vision exam, and a driving skills test.

Why did I get a functional ability evaluation medical report?

A functional capacity evaluation (FCE) is a standard assessment that measures your physical abilities in relation to your typical job tasks to evaluate if and when you can resume working. Here, we explain why FCEs are ordered and what to expect from your own evaluation.

How long after a seizure can you drive in Utah?

Driver Information By State LawUtah DMV Appeal of License Denial Yes Doctors to Report Epilepsy No Periodic Medical Updates Required After Licensing At discretion of Medical Advisory Board Seizure-Free Period 3 months, with exceptions

What is the purpose of a functional capacity evaluation?

Functional capacity evaluations (FCE) are comprehensive tests that assess the physical abilities of people who have suffered a work-related injury. Our evaluation helps determine whether you are ready to return to work or if any restrictions or accommodations should be implemented so you can return to work safely.

What is a functional ability evaluation medical report?

A functional capacity evaluation (FCE) is a set of tests that are used to identify a persons physical skills, functional capabilities, activity endurance, and work tolerances. The FCE is a 6-to-8-hour evaluation that is administered over two days by an occupational therapist or physical therapist.

functional ability evaluation medical report utah

Functional Ability evaluation medical REPORT form Utah drivers License Division Unsafe driver report Utah Utah DMV utah code 53-3-303 Utah drivers license sleep apnea Utah DMV eye test Medical form for drivers License

What happens after an FCE evaluation?

There may be stipulations based on your states agency, but it is commonly used in workers compensation cases to assess an injured workers ability to return to their job duties safely and effectively. After an FCE, your employer will determine modifications or accommodations needed to support your return to work.

What is the purpose of the functional ability assessment?

The FAE allows objective collection of information on your abilities and limitations, and provides data interpreted for use in injury/accident compensation matters, as well as a work reintegration process.

How to report a reckless driver in Utah?

CALL 911 to report one of these or another emergency situation. If you need to report damage to your vehicle or wish to obtain a copy of a police report, please contact your local dispatch center.