When vision is in question during a Georgia DDS medical review or licensing, the driver's eye doctor reports on this one-page form. The optometrist or ophthalmologist checks the driver against the vision requirements of O.C.G.A. 40-5-27 and selects whether they meet them, meet them with restrictions, or lack sufficient vision to drive safely, giving reasons.
The driver completes and signs the Driver/Patient Section, authorizing the eye doctor. The optometrist or ophthalmologist completes the Optometrist/Ophthalmologist Section with name, license number and state, address, finding, signature and exam date.
Download the current version from the source each time; forms change without notice.
Vision Form (Vision Report Form)
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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Under O.C.G.A. 40-5-27, as printed on the form: acuity of 20/60 or better in at least one eye, corrected or uncorrected, and a horizontal field of at least 140 degrees with both eyes open. With only one usable eye, the field must reach 70 degrees temporally and 50 nasally.
The eye doctor. After the driver completes the patient section, the optometrist or ophthalmologist completes and signs the form and must mail or fax it to the DDS Medical Review Unit. It is often requested together with the DDS-MR 287 Medical Report during a medical review.