Form PS30338 template
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Vision Report (Visual Acuity)
The document is a vision report form used in Minnesota for drivers undergoing vision examinations. The form contains sections for both the patient and the licensed vision examiner to fill out. It includes fields for collecting personal information, vision acuity readings, and recommended restrictions based on vision impairments. The form specifies various types of restrictions such as daylight only, maximum speed limits, area restrictions, road restrictions, and equipment restrictions. The document also contains information about data privacy and where to submit the completed form.
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