This form may be used to record: - mva maryland 2026

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The document is a Vision Screening Form from the Motor Vehicle Administration (MVA) of Maryland, used to record vision screening results for drivers. It includes sections for MVA's vision screening findings and a vision specialist's examination results, detailing visual acuity, field of vision, and color vision capabilities. The form also addresses whether corrective lenses are needed and if any medical conditions may affect driving eligibility. It requires certification from an ophthalmologist or optometrist.

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Click ‘Get Form’ to open it in the editor.
Begin by entering the Driver/Patient’s full name and Maryland driver’s license number at the top of the form.
Fill in the MVA Vision Screening Results section, noting acuity for both eyes without and with lenses. Ensure to include field of vision details.
In the Vision Specialist’s Examination Results section, provide the examination date and fill out acuity information for each eye as well as binocular vision status.
Answer all yes/no questions regarding corrective lenses, treatment improvements, and any medical reasons that may affect driving eligibility.
Finally, have the ophthalmologist or optometrist sign and date the form, ensuring all required fields are completed before submission.

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