Applicants who don't pass the Alaska DMV vision screening bring this one-page assessment to a physician or optometrist. The examiner records visual acuity in each eye and both eyes together, notes whether corrective lenses were used, answers whether the person can drive safely with current vision, and can recommend restrictions. Alaska's vision standards from 2 AAC 90.440 are printed beneath.
A physician or optometrist completes the whole form and adds name, title, signature, exam date and office details. The applicant only writes their name at the top.
Download the current version from the source each time; forms change without notice.
Eye Examination and Physician or Optometrist Assessment
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When an applicant fails the vision screening at the DMV. The applicant takes this form to a physician or optometrist, who measures acuity and gives an opinion on safe driving. For broader medical, seizure or mental health questions, Alaska DMV uses the Confidential Eye/Medical/Mental Examination Report, Form 468.
Under the standards printed on the form, DMV only issues a license when best corrected vision in both eyes together is 20/100 or better. Between 20/50 and 20/100, an eye specialist exam is required and restrictions may apply. A commercial license requires 20/40 or better.