Form PS31015 template
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Loss of Consciousness or Voluntary Control Waiver
The document is a loss of consciousness or voluntary control report for Minnesota Department of Public Safety Driver and Vehicle Services. It includes instructions for both the driver and physician to complete sections regarding episodes of lost consciousness or voluntary control, frequency of reports, diagnosis, and contact information. The form also mentions immunity from liability for physicians reporting to DVS and consequences of not submitting data in 30 days.
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