MVA Online Vision Certification Service
Logged in as: [Name]

Vision Information

All fields are required, or as indicated.

Enter the examinations findings for Jane Doe Thomas.

Examination Findings
(Format: MM/DD/YYYY)

 

Enter the vision examination findings for Jane Doe Thomas below.

  Without Lenses OR With Lenses AND Horizontal Field of Vision
Right
 20/  20/   degrees
Left
 20/  20/   degrees
Both
 20/  20/   degrees

Did the visual exam reveal any medical reason that could preclude granting a license, so that a review by the MVA Medical Advisory Board is necessary?

 

Can the patient distinguish between red, green and amber colors?

Your Ophthalmologist/Optometrist (designees only)

Select the Ophthalmologist or Optometrist on whose behalf you are submitting this information.

Cancel

 Your Progress

  • Patient Information
  • Vision Information
  • Review and Certify

 Administration

 Links & Resources

 Support