25cc2599_Affairs_Forms_and_Publications__Description
[Form] Class D and M Vision Screening Certificate [Instructions] Have your eye care provider complete and sign this form in the appropriate sections. Bring the completed Vision Screening Certificate with you when you come in to apply for or to renew your license. [Description] 
This form is used in lieu of the RMV eye exam and must be signed by an optometrist or physician.
Massachusetts RMV - Medical Affairs Forms and Publications
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