Form HSMV72190 Medical Referral Form - Florida

Form HSMV72190 Medical Referral Form - Florida

What Is Form HSMV72190?

This is a legal form that was released by the Florida Department of Highway Safety and Motor Vehicles - a government authority operating within Florida. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form HSMV72190?A: Form HSMV72190 is the Medical Referral Form used in the state of Florida.

Q: Who uses Form HSMV72190?A: Form HSMV72190 is used by medical professionals in Florida to refer individuals for medical evaluation when applying for a driver's license or identification card.

Q: What is the purpose of Form HSMV72190?A: The purpose of Form HSMV72190 is to assess an individual's medical fitness to operate a motor vehicle and determine if any restrictions or exemptions should be applied.

Q: How do I obtain Form HSMV72190?A: You can obtain Form HSMV72190 from any medical professional licensed in Florida who is authorized to perform examinations for the Department of Highway Safety and Motor Vehicles.

Q: What information is required on Form HSMV72190?A: Form HSMV72190 requires the individual's personal information, medical conditions and treatments, and the medical professional's recommendations.

Q: Are there any fees associated with Form HSMV72190?A: No, there are no fees associated with submitting Form HSMV72190.

Q: Can I refuse to complete Form HSMV72190?A: In most cases, refusal to complete Form HSMV72190 may result in the denial of a driver's license or identification card.

Q: How long is Form HSMV72190 valid?A: Form HSMV72190 is valid for 1 year from the date it is signed by the medical professional.

Q: Can I appeal the recommendations on Form HSMV72190?A: Yes, you can appeal the recommendations on Form HSMV72190 by providing additional documentation or seeking a second opinion from another medical professional.

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Form Details:

  • Released on July 1, 2018;
  • The latest edition provided by the Florida Department of Highway Safety and Motor Vehicles;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form HSMV72190 by clicking the link below{class="scroll_to"} or browse more documents and templates provided by the Florida Department of Highway Safety and Motor Vehicles.

Download Form HSMV72190 Medical Referral Form - Florida

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