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New Hampshire DSMV 125: Out-of-State Eye Exam

New Hampshire requires license holders to pass a visual acuity exam in person once every five years before renewal. Residents temporarily out of state who cannot return before their six-month temporary license expires give this two-page form to a licensing examiner or eye doctor where they are. The examiner records acuity and signs, and the driver mails the form to the DMV.

Who completes it

The driver fills in their name, date of birth, license number, New Hampshire and temporary addresses, and signs. An authorized licensing examiner or eye doctor records the visual acuity results on page 2 and signs and dates it.

Submitting and payment

How to submit it
The examiner returns the completed form to the driver, who mails it to the New Hampshire DMV, Attention: Driver Licensing. The form is not accepted unless it is properly completed and signed.

Good to know

  • Record acuity for the right eye, the left eye and both eyes, each without and with corrective lenses, as a 20/ value.
  • If the results meet New Hampshire's minimum standards, the DMV issues a temporary license valid until the expiration date shown on the driver license.
  • Military personnel are exempt from re-examination; they furnish an affidavit certifying active status in the armed forces and assignment outside New Hampshire.
  • The current version is Rev 3/22. The in-state counterpart for an eye doctor's report is DSMV 61, the Eye Examination form.

Get the official form

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

Eye Examination - Out-of-State (Re-Examination Instructions to New Hampshire Residents Temporarily Out-of-State)

Official pagePDF

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

How does a New Hampshire driver renew while temporarily out of state?

If they cannot return before their six-month temporary license expires, they give DSMV 125 to an authorized licensing examiner or eye doctor where they are. The examiner gives the vision test, records the results, signs, and returns the form to the driver, who mails it to the DMV's Driver Licensing section.

Do military members need DSMV 125?

No. Military personnel are exempt from re-examination and furnish an affidavit certifying active status in the armed forces and assignment outside New Hampshire. Other license holders who are temporarily out of state use DSMV 125 so an examiner or eye doctor can record their visual acuity.

What vision test does the out-of-state examiner use for DSMV 125?

The form asks the examiner to administer their own vision test, so no specific chart is prescribed. Page 2 records visual acuity for each eye and both eyes, with and without corrective lenses. The DMV then checks the results against New Hampshire's minimum standards before issuing the temporary license.