DRIVING CONTRACT - Akron Children's Hospital 2025

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  1. Click ‘Get Form’ to open the DRIVING CONTRACT in the editor.
  2. Begin by entering your personal information at the top of the form, including your name and date.
  3. Review the requirements for signing the medical evaluation form. Ensure your hemoglobin A1C is below 9 percent, as this is crucial for eligibility.
  4. In the agreement section, confirm your commitment to test your blood sugar four times daily and before driving. You can check off each requirement as you read through them.
  5. Sign and date the form in the designated areas for patient, parent, and witness signatures. Make sure all signatures are clear and legible.
  6. Once completed, save your document. You can easily share it with your provider or print it directly from our platform.

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