New York drivers renewing online or by mail need proof of a passed vision test, and the MV-619 is that proof when the testing provider is not enrolled in DMV's Vision Registry. The provider records the exam date, whether the patient reached 20/40 on the Snellen test with one or both eyes, and lens use, then hands the signed report to the patient.
A licensed physician, physician assistant, registered nurse, nurse practitioner, optician, optometrist, ophthalmologist, or supervised staff of any of these fills in items 1 to 11, including the patient's identifying details, and signs item 10. The patient has no section of their own and simply uses the finished report to renew.
Read these before testing. The form is only for patients with a minimum Snellen score of 20/40 with one or both eyes, with or without corrective lenses. Patients whose best corrected vision falls between 20/40 and 20/70, or who use telescopic lenses, need form MV-80L. Only the listed licensed professions or their supervised staff may complete it. Print in ink or type everything except the signature, and give the finished report to the patient rather than mailing it.
Enter the patient's last name, first name and middle initial exactly as they appear on the patient's driver license. Give the date of birth as MM/DD/YY. Item 3 takes the patient's street address with apartment number, city, state (if in the U.S.), country and zip code. Print in ink or type these entries like the rest of the form.
Record the date the vision test was performed in MM/DD/YY format. Item 9 measures the report's validity from this date of examination, so enter the day the patient was actually tested rather than the day the form is printed or signed.
Item 5 asks whether the patient achieved a Snellen score of 20/40 or better with one or both eyes; check Yes or No. The form prints the consequence of a No answer beside the boxes: complete form MV-80L instead. Item 6 asks whether the patient wore corrective lenses during the test; check Yes or No.
Enter the provider's name and professional title, then the provider's street address, city, state (if in the U.S.), country and zip code. The title should show one of the professions the instructions authorize: physician, physician assistant, registered nurse, nurse practitioner, optician, optometrist or ophthalmologist.
Check one box to state that the report is valid for up to 12 months or up to 6 months from the date of examination. The patient relies on the report only within the period you mark, so the choice matters when the license renewal is still some months away.
Item 10 is the certification: "I have examined the patient described above, and have accurately reported my findings." Sign your name in full beside the X. Item 11 takes the certifying provider's professional license number. The edition printed at the foot of the page is MV-619 (5/22).
Download the current version from the source each time; forms change without notice.
Vision Test Report
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.
Sources for this guide
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Only a licensed physician, physician assistant, registered nurse, nurse practitioner, optician, optometrist or ophthalmologist, or supervised staff of one of these providers, may complete it. The provider prints or types every entry except the signature, signs item 10 in full, and adds a professional license number in item 11. DMV office staff can also test the driver instead.
The provider decides between two options printed in item 9: valid for up to 12 months or up to 6 months from the date of examination. For residents renewing online from outside New York, DMV separately requires an eye exam from the last 12 months saved to the Vision Registry, which a paper MV-619 does not replace.
Answer No to item 5 and do not use the MV-619 for renewal. The form directs providers to complete form MV-80L, the eye test report for the Medical Review Unit, for patients whose best corrected vision is below 20/40 but not below 20/70, and for patients who wear telescopic lenses. The MV-80L is mailed to the address printed on it.
No. The patient instructions on the form say that if a provider enrolled in DMV's Vision Registry completes the required vision test, the driver does not need the MV-619 to renew. The result is stored in the Registry, and drivers can search for a nearby enrolled provider with DMV's vision registry locator.