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Get and Sign Contact Us Driver ControlDepartment of Revenue Motor Vehicle 2020-2022 Form
Operate a motor vehicle safely
and responsibly.
• My physician will respond to any additional questions from the Department of Motor Vehicle (DMV).
• I understand that this form will be considered in any decision regarding the issuance of my driver license,
pursuant to C.R.S. 42-2-111 & 42-2-112.
Signature of Driver or Patient
Date (MM/DD/YY)
Driver/Patient (respond to all questions below before seeing your physician)
1. How many driving trips do you make in a typical week?
2. Do any of...
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