Nova Scotia Eye Examination Report for Drivers

Nova Scotia uses this one-page report to check a driver's vision against the standard for the licence class held or applied for. The optometrist or ophthalmologist records Snellen acuity with and without correction, colour vision, diplopia, eye disease and visual field defects, then states whether the patient meets the standard and whether corrective lenses, a daylight-only restriction or follow-up are needed.

Who completes it

An optometrist or ophthalmologist licensed to practise in Nova Scotia completes the findings and signs; the driver fills in personal details and licence class and signs consent for the vision specialist to report to the Motor Vehicle Administration.

Submitting and payment

How to submit it
Return it by mail or fax to the Motor Vehicle Administration contacts in the form header; that fax number matches the one the current Driver's Medical Examination Report gives for the Medical Fitness section.

Good to know

  • Colour vision is recorded as whether the patient can accurately identify red, green and amber.
  • Classes 1, 2 and 4 need 120 degrees of field in each eye examined separately; the other classes need 120 degrees with both eyes open and examined together.
  • The examiner states whether follow-up is required and when, alongside recommendations on corrective lenses and a daylight-only driving restriction.
  • The posted form (CER12Form22Z, Rev11/07) still carries the former Service Nova Scotia and Municipal Relations header and has no fillable fields.

Get the official form

Download the current version from the source each time; forms change without notice.

Eye Examination Report

Fill it with Vero

If your copy of the form is a fillable PDF, upload it once and Vero Documents fills it from the visit note and the chart, ready for you to review and sign. Download, print, or email the finished form, with the patient’s consent.

How this list is checked

A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms change without notice, so download the current version from the official page before you fill it in.

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Frequently asked questions

Who can complete the Nova Scotia Eye Examination Report?

The form states it must be completed by an optometrist or ophthalmologist, and the examiner certifies being licensed to practise ophthalmology or optometry in Nova Scotia. The driver signs a consent authorizing the vision specialist to report findings to the Motor Vehicle Administration Section.

What visual acuity does Nova Scotia require for drivers?

The form prints the standards. Classes 3, 5, 6, 7 and 8 need at least 20/40 (6/12) in the better eye. Classes 1, 2 and 4 need at least 20/30 (6/9) in the better eye and 20/50 (6/15) in the poorer eye, measured on a Snellen chart.

Can the eye report lead to a daylight-only licence?

The examiner can recommend it. The form asks whether the patient needs corrective lenses for driving, needs a daylight driving only restriction and already has the recommended correction, and whether the patient meets the vision standards for the licence class checked at the top of the form.