Form D4 Minnesota

Ophthalmologist Examination Report

An individual named (Patient's name) is seeking a waiver from Minnesota Department of Public Safety for intrastate school bus driving, following an ophthalmologist examination. The report requests information on the patient's diabetic condition's impact on visual health. The examining ophthalmologist should answer the following questions regarding the patient's: unstable proliferative diabetic retinopathy status, Snellen distant visual acuity (Left: 20/ Right: 20/), Horizontal Fields in Degree for each eye (Left Eye: _____ Right Eye: _____ BothEyes: _________), whether the patient reads with or without corrective lenses, and if their visual acuity is stable. The ophthalmologist should also provide their name, office/clinic name, telephone number, sign the report, and ensure that it has been examined within the preceding six months.

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Driving License Application Forms

In most countries, it's mandatory to have a driving license before you can hit the road. Getting a driving license is an important milestone for anyone who wants to drive a car.

Form D4 is one of Driving License Application forms that are documents used to gather information from people who want to apply for a driving license. It usually contains fields for the applicant's name, date of birth, ID number, contact information, as well as their driver's license history and experience.

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