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Montana 22-1801: MVD Eye Evaluation Form

Montana's Motor Vehicle Division uses this one-page form to verify that a driver meets the state's vision standards for license issuance. An eye specialist records acuity without correction, with current correction and with any new prescription, plus field breadth, double vision, eye disease, night vision and color deficiencies, and recommends any MVD monitoring interval.

Who completes it

The driver fills in identification and signs the release in the eye specialist's presence; an optometrist or ophthalmologist completes the vision test and signs the certification.

Submitting and payment

How to submit it
Return it to the MVD by mail, fax or email, using the contact details printed in the form header.
Who pays
The driver's release states that any expense involved is charged to the driver, not the State of Montana.

Good to know

  • Breadth of vision field, measured to the right and left of fixation with the total angle, is required for commercial driver license holders.
  • Fields marked with an asterisk are required, including the patient's name, phone and date of birth and the specialist's name, specialty, license number, phone and signature.
  • The form's explanation says the eye specialist assumes no responsibility in making the report other than precisely representing the facts.
  • The form asks which instrument measured acuity, a vision testing system or a Snellen chart, and whether any double vision can be corrected with lenses.

Get the official form

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

Eye Evaluation

Official pagePDF

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.

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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 and their requirements change without notice, so check the official page for the current version before you complete one.

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Frequently asked questions

Who can complete Montana's Eye Evaluation form?

An eye specialist, meaning an optometrist or ophthalmologist, completes the examination and certification. The driver signs the release of information in the specialist's presence, and the form goes back to MVD to verify that the driver meets Montana vision standards. The current version is dated 9/18/25.

Is the visual field required on Montana form 22-1801?

The breadth of vision field section, measured to the right and left of the point of fixation with the total angle, is marked as required for CDL drivers. Acuity without correction and with current correction are required fields for every driver.