CER12Form22ZEye Examination Report
Vision report on acuity, colour vision, diplopia and visual fields against Nova Scotia licence-class standards.
- Completed by
- Optometrist or ophthalmologist
- Issued by
- Nova Scotia RMV
- Format
- Language
- English
Nova Scotia requires this report when a driver first applies for a class 1, 2, 3 or 4 licence, at renewal, annually after age 64, and whenever the Registry asks for medical information. The examiner reports vision against class standards, works through a system-by-system checklist and recommends issuing, restricting or suspending the licence. A committee of medical specialists helps the department review the reports.
The patient completes and signs Part 1, consenting to release of medical information; a family physician, walk-in or locum physician, specialist or nurse practitioner completes Parts 2 to 5, and a different professional who does the vision testing is named in Part 2.
Download the current version from the source each time; forms change without notice.
Driver's Medical Examination Report
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At first application for a class 1, 2, 3 or 4 licence, at renewal, and annually after age 64. The Registry may also ask for medical information at its discretion, including from class 5 to 8 drivers with a specific condition, and re-applying for class 1 to 4 after a licence lapsed over five years requires a satisfactory medical.
Part 5 lets the examiner identify as the driver's family physician (with years of care), a walk-in or locum physician (stating whether the chart was reviewed), a specialist or a nurse practitioner. If another professional does the vision testing, their name and the date go in Part 2.
The form prints it: at least 20/30 (6/9) in the better eye, at least 20/50 (6/15) in the poorer eye, and 120 degrees of horizontal field in each eye. Class 3 and classes 5 to 8 need 20/40 (6/12) in the better eye and 120 degrees with both eyes open.