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WebVision Program 1200 New Jersey Ave., SE Room W64-224 Washington, D.C. 20590 Upon receipt of current and complete information, an individual evaluation for an exemption … WebIf yes, please submit a Maryland MVA DC-220 form. 4. Will treatment improve this patient’s vision for driving? yes no 4a. If yes, Diagnosis/Treatment _____ I certify under penalty of perjury that the information contained hereon is true and accurate to the best of my knowledge, information, ... Vision Screening Form. DL-043A (08-18) can massachusetts schools go remote

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