California DMV gives this form to a driver who does not meet its visual acuity screening standard and asks them to see a vision specialist. The ophthalmologist or optometrist records refraction, acuity, diagnosis, prognosis, visual fields and driving advice; the driver brings the completed report back to DMV, which makes the final licensing decision, sometimes after a driving performance evaluation.
The applicant completes Section 1 and signs the authorization. A licensed ophthalmologist (M.D.) or optometrist (O.D.) completes Section 2: only Visual Acuity and Signature if the patient meets DMV's screening standard, otherwise all nine numbered parts.
The applicant enters driver license number, date of birth, phone, name and address, then signs and dates the authorization that lets the vision specialist give DMV the exam results for confidential use under CVC §1808.5. Check that it is signed before you release the form, since an incomplete required section can send it back to you.
Complete only what applies: whether new distance lenses were prescribed and fitted (glasses or contacts) and the date, whether monovision is used by contact lenses or refractive surgery, and whether best corrected acuity in each eye is recommended for driving. For bioptic users, record bioptic acuity in each eye and whether the telescope is suitable for driving.
Enter clinical acuity without a bioptic telescope for both eyes, right and left: without lenses, with current lenses, and best corrected. The DMV Measurement row is for DMV use only. Answer whether the patient had bioptic lens training, training that included driving, and skill using the telescope, and whether night driving is recommended. Parts 2 and 9 are required on every DL 62.
Check the condition and the affected eye, right or left, from grouped lists: refractive, developmental, optical, retinal or optic nerve, and visual fields, such as cataract, glaucoma, macular degeneration, diabetic retinopathy or hemianopia. Write unlisted diagnoses under other diagnosis/comments. Record monocular vision with its onset, any eye surgery including refractive, and the date and type of the most recent surgery.
For up to three diagnoses, mark static or progressive and the date stable since. Then tell DMV when it should require a new vision examination report: not applicable, 1 year, 2 years, 5 years or other. This answer tells DMV how often to ask the driver for a new DL 62 vision report.
If vision is not correctable to 20/40 in each eye or field loss is possible, a full visual field examination is required, and confrontation is permissible. Draw the approximate peripheral extent and any scotomas on the left and right eye diagrams and enter the extent left, right, up and down for each eye.
Rate each abnormality the patient may have, per eye, as 1 (mild), 2 (moderate) or 3 (severe): decreased acuity, visual field loss, contrast sensitivity loss, problems with glare, poor night vision, color defect, abnormal eye movements and reduced depth perception. DMV's examiners use these ratings to judge the patient's ability to drive safely.
Part 7 asks whether you have given the patient any advice about driving; if yes, explain it in part 8. Part 8 is for anything DMV should know about the patient's visual and perceptual capabilities related to driving, conditions behind poor night vision or depth perception, and recommendations about general safety. An extra sheet may be attached.
This part must be completed to validate the report: printed name, M.D. or O.D., license number, signature, date of exam, address and phone. The exam date must be within the last six months. DMV makes the final licensing decision based on several factors, including the specialist's findings.
Download the current version from the source each time; forms change without notice.
Report of Vision Examination
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A licensed ophthalmologist or optometrist. Section 9 asks for the printed name, M.D. or O.D. license number, signature, date of exam and office details, and it must be completed to validate the report. The applicant fills in and signs Section 1, authorizing the specialist to share the results with DMV.
The exam date in Section 9 must be within the last six months. DMV's senior driver guidance says a DL 62 submitted within the previous six months doesn't have to be redone, unless the driver had eye surgery during that period, in which case a new report is required.
No. The form tells applicants to bring it, along with any new corrective lenses, when they return to DMV, and not to mail it unless a DMV employee asks. DMV also suggests waiting until the driver is used to new lenses, since a driver may fail the vision test with unfamiliar ones.
Yes. Section 4, Prognosis, asks whether each diagnosis is static or progressive and stable since what date, then asks when DMV should require a new vision examination report: not applicable, 1 year, 2 years, 5 years or another interval you specify.