Washington's Department of Licensing sends this report when it has reason to believe a driver's vision may affect safe driving. An ophthalmologist or optometrist records acuity with and without correction from an exam within the past year, whether a bioptic was used, horizontal field loss, diplopia, and whether DOL should monitor the driver with periodic reports. DOL alone makes the licensing decision.
The driver, or a parent for a minor, signs the consent to release information. The ophthalmologist or optometrist answers all questions, adds comments on other conditions and signs under penalty of perjury.
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Yes. DOL publishes a Spanish version, Informe del examen de la vista, as well as Russian and Vietnamese versions. The clinician section asks for the same information in each: acuity with and without correction, field of vision, diplopia and monitoring recommendations.
The driver's consent covers an examination conducted within the past year, and the form asks for a date of examination within the past year. The completed report must reach DOL by the date written on the form, or the driver's privilege may be suspended.