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Get and Sign Medical Examination ReportDrivers Licence This Report Serves to Assess a Drivers Overall State of Health  Form

Get and Sign Medical Examination ReportDrivers Licence This Report Serves to Assess a Drivers Overall State of Health Form

Use a Medical Examination ReportDrivers Licence This Report Serves To Assess A Drivers Overall State Of Health template to make your document workflow more streamlined.

Disease occupational deafness etc. Right Hearing loss Left Changing condition Is the person able to perceive a forced whispered voice at a distance of 1. 5 metres With a hearing aid Without a hearing aid 3 Neurological disorders Parkinson s MS epilepsy syncope CVA/TCI brain aneurysm head trauma brain tumour dementia etc. If functional limitations are related to diagnosis complete section 8. 5 metres With a hearing aid Without a hearing aid 3 Neurological disorders Parkinson s MS epilepsy...
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