Form HSMV 72119. Mature Driver Vision Test - Florida

The Form HSMV 72119, known as the Mature Driver Vision Test, is a document issued by the Florida Department of Highway Safety and Motor Vehicles. This form is used to assess the visual acuity of mature drivers (typically aged 80 and above) during the driver's license renewal process.

The main purpose of this form is to evaluate the vision capabilities of mature drivers to ensure that they meet the required visual standards for safe driving. It aims to identify any potential vision impairments that may affect their ability to operate a motor vehicle safely.

The form typically consists of the following sections:

• Driver's personal information (name, address, date of birth)
• Visual acuity test results, including distance and near vision measurements
• Information about the eye care professional conducting the vision test
• Declaration of the accuracy of the information provided
• Signature of the driver and eye care professional

When filling out this form, it is important to provide accurate personal information and ensure that the visual acuity test results are correctly recorded. The eye care professional administering the test should carefully review and validate the information before signing the form. Compliance with the established visual acuity standards set by the Department is crucial.

No additional documents need to be attached when submitting this form. However, it is advisable for mature drivers to bring their corrective lenses or glasses, if applicable, during the vision test to ensure accurate measurements.

An example of an application for this form would be a mature driver who is renewing their driver's license. The Mature Driver Vision Test allows for the assessment of their visual acuity and ensures that their vision meets the necessary standards for safe driving.

A related form is the Report of Eye Exam (Form HSMV 72010), which is used for individuals of all ages to report the results of an eye examination conducted by a licensed eye care professional. While the Mature Driver Vision Test focuses specifically on mature drivers, the Report of Eye Exam applies to individuals in general and is required for various driver's license-related processes.