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The document is a Physician's Statement form required by the Texas Department of Public Safety to indicate health conditions that may affect communication with law enforcement. It allows individuals with specific conditions, such as autism, speech disorders, or hearing impairments, to have a 'Communication Impediment' or 'Deaf or Hard of Hearing' indicator on their driver license or ID. The form must be completed by both the patient and a licensed physician and submitted to the department for processing.

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