[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-432271-105":3,"detail-sidebar-cat-0-en-105":81,"doc-detail-432271-en":130},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","dds-vision-report-instructions","DDS Vision Report - Instructions","","DDS Vision Report instruction form for completing a driver vision examination in Georgia. Requires completion by a licensed optometrist or ophthalmologist, with mailing or fax submission to the Medical Review Unit when license restrictions are not met. Collects patient identity and attestation, then records visual acuity, horizontal field measurements, monocular vision status, and any need for non‑conventional correction. Includes physician statements on double vision, eye disease or injury, and whether the person can safely operate a motor vehicle, plus signature and license details.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/dds-vision-report-instructions/432271/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/dds-vision-report-instructions/432271.png","ImageObject",300,407,{"name":42,"@type":43},"kopisore","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-30","2026-09-29",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",10,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"Who must complete the Georgia DDS Vision Report?","Question",{"text":63,"@type":64},"A licensed optometrist or ophthalmologist must complete the report. It should not be completed for Commercial Motor Vehicle Drivers.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"What happens if a driver does not meet the requirements to return the form to a customer service center?",{"text":68,"@type":64},"All pages of the report must be mailed or faxed (with coversheet) by a licensed optometrist or ophthalmologist directly to the Department of Driver Services, Medical Review Unit.",{"name":70,"@type":61,"acceptedAnswer":71},"What vision requirements must a driver meet to be issued a license?",{"text":72,"@type":64},"The report states requirements including visual acuity of 20/60 or better in at least one eye, a horizontal field of vision of at least 140 degrees with both eyes open, and specific field limits when only one eye has usable vision.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},432271,1790915686,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,120,123,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":116,"doc_module":4,"doc_module_name":25,"category_name":117,"show_sort_weight":118,"slug":119},9,"Religion & Spirituality",20,"religion-spirituality",{"id":118,"doc_module":4,"doc_module_name":25,"category_name":121,"show_sort_weight":118,"slug":122},"World Cup","world-cup",{"id":55,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":55,"slug":125},"Lifestyle","lifestyle",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":97,"slug":129},19,"General","general",{"code":4,"msg":82,"data":131},{"doc_id":79,"user_id":132,"nickname":42,"user_avatar":133,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":26,"language":139,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":12,"update_tm":143,"read_time":97,"preview_page_count":4},962090880963,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","GEORGIA DEPARTMENT OF DRIVER SERVICES VISION REPORT  \nINSTRUCTIONS  \nIMPORTANT:  \n1. This report MUST be completed by a licensed optometrist or ophthalmologist. (This report should not be completed for Commercial Motor Vehicle Drivers.)  \n2. If cleared to drive without the addition and/or removal of license restriction(s), a Non-Bioptic customer may return this form to any Department of Driver Services Customer Service Center.  \n3. If you do not meet the requirements outlined in \\#2 (above), all pages of this report MUST be mailed or faxed (with coversheet) by a licensed optometrist or ophthalmologist directly to:  \nDepartment of Driver Services  \nMedical Review Unit  \nP. O. Box 80447  \nConyers, Georgia 30013 or  \nFax to (770) 344-3629  \nPATIENT INFORMATION  \nName: Last   First   MI   DOB (mm/dd/yyyy):    \nPhysical Street Address:   City   State   Zip Code   Driver’s License \\#    \nPATIENT ATTESTATION  \nI authorize   , a licensed optometrist or ophthalmologist, to complete this examination and to provide further clarification or information about my visual acuity to the Georgia Department of Driver Services (DDS) . I agree that this Vision Report may be submitted to the DDS Driver’s License Advisory Board, which consists of doctors licensed to practice throughout the State of Georgia, and that it may also be used for the guidance of the courts when necessary.  \nDriver/Licensee Signature Date  \nREPORT ON VISUAL EXAMINATION  \nPursuant to Georgia Law (O.C.G.A. §40-5-27) a driver must meet the following vision requirements to be issued a license:  \n• Visual acuity of 20/60 or better, corrected or uncorrected in at least one eye  \n• Horizontal field of vision with both eyes open of at least 140 degrees  \n• In the event that only one eye has usable vision, the horizontal field of vision must be at least 70 degrees temporally and 50 degrees nasally.  \nIf possible, measure the below at 20 feet. If not, state the distance used:    \nBEST CORRECTED VISUAL ACUITY (BCVA)  \nHORIZONTAL PERCEPTION (Must be tested)  \nPlease state the horizontal field of vision in degrees.  \nRight:   degrees Left:   degrees Total:   degrees  \nMONOCULAR VISION  \nDoes this person have monocular vision? 􀂆 Yes 􀂆 No If yes, please state the nasal and temporal fields in degrees. NASAL FIELD   degrees TEMPORAL FIELD   degrees  \n􀂆 Check here if correction is achieved with other than conventional lenses. If box is checked, a detailed report must be attached.  \nVISION REPORT PHYSICIAN’S STATEMENT  \nDate of Examination (mm/dd/yyyy):    \n1. Is there double-vision? 􀂆 Yes 􀂆 No If ‘Yes’, is it corrected with glasses or other treatment? 􀂆 Yes 􀂆 No  \n2. Is there any evidence of eye disease, condition or injury? 􀂆 Yes 􀂆 No If ‘Yes’, please describe:  \na. Can this be corrected or compensated for? 􀂆 Yes 􀂆 No 􀂆 NA  \n3. In your opinion, does this person have sufficient vision to safely operate a motor vehicle? 􀂆 Yes 􀂆 No  \na. If yes, should any restrictions be imposed? 􀂆 Yes 􀂆 No If ‘Yes’, please check the applicable restriction(s) below:  \nRestriction Code/Description  \n 1 - Bioptic lenses required  \n B - Corrective lenses required  \n G - Daylight hours only (if difficulty seeing in dim light or at night)  F - Right exterior mirror required  \n I - Left exterior mirror required  \n R - No Highway/Interstate  \n Other - Please explain  \nPHYSICIAN ACKNOWLEDGEMENT  \nI,   , being licensed to practice optometry/ophthalmology, certify that I have personally examined the vision of the above-named individual, that a true record of this examination appears on this report and that he or she signed this form in my presence.  \nName of Practice    \nPhysician Full Name: Last:   First:   M.I.    \nSpecialty:    \nLicense Number/State    \nAddress:    \nCity:   State:   Zip:    \nTelephone Number:   -   -    \nPhysician Signature Date","cbCaijAg9oo5qB7H","https://ap.wps.com/l/cbCaijAg9oo5qB7H","pdf",172602,"English","# PATIENT INFORMATION\n# PATIENT ATTESTATION\n# REPORT ON VISUAL EXAMINATION\n## BEST CORRECTED VISUAL ACUITY (BCVA)\n## HORIZONTAL PERCEPTION (Must be tested)\n## MONOCULAR VISION\n# VISION REPORT PHYSICIAN’S STATEMENT\n# PHYSICIAN ACKNOWLEDGEMENT","[{\"question\":\"Who must complete the Georgia DDS Vision Report?\",\"answer\":\"A licensed optometrist or ophthalmologist must complete the report. It should not be completed for Commercial Motor Vehicle Drivers.\"},{\"question\":\"What happens if a driver does not meet the requirements to return the form to a customer service center?\",\"answer\":\"All pages of the report must be mailed or faxed (with coversheet) by a licensed optometrist or ophthalmologist directly to the Department of Driver Services, Medical Review Unit.\"},{\"question\":\"What vision requirements must a driver meet to be issued a license?\",\"answer\":\"The report states requirements including visual acuity of 20/60 or better in at least one eye, a horizontal field of vision of at least 140 degrees with both eyes open, and specific field limits when only one eye has usable vision.\"}]","DDS Vision Report - Instructions | PDF",1790658898]