Transcription of Driver Licence Medical
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Driver Licence Medical
10,003 (02/2021). Driver Licence Medical This Driver Licence Medical form is applicable for Licence classes C, R and LR. Any Licence class above LR requires a Commercial Drivers Medical Assessment to be submitted. Medical forms can be obtained by visiting or calling Access Canberra on 13 22 81. If the Driver Licence Medical is submitted incomplete it cannot be accepted by the Road Transport Authority. Personal details New Licence application Existing Licence application Surname Given name Other names Date of birth Licence number Contact number Residential address Email address Visual Acuity Are corrective lenses required for driving?* Yes No *If corrective lenses are required visual acuity must be recorded with corrective lenses on. Visual Acuity - please specify Both 6/ Right 6/ Left 6/.
The Driver Licence Medical is valid for six months from the date of examination. The Road Transport Authority does not acknowledge the return of medical assessment reports. If there is a problem with the report or the report is not received by the due date, you will be contacted. Medical examination requirements for holders of an ACT Driver Licence
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