Get the free 735-7230. Mandatory Impairment Referral - odot state or

THE MEDICAL INFORMATION IN THIS REPORT IS CONFIDENTIAL AND WILLIE USED BY THE DRIVER AND MOTOR VEHICLE ... COUNTY. (OAR CHAPTER 735 DIVISION 74) ... FAX or Mail Instructions on Reverse of form ...

How to fill out 735-7230 mandatory impairment referral

How to fill out 735-7230 mandatory impairment referral:

1. Start by gathering all relevant information about the individual who needs the referral. This may include their full name, date of birth, contact information, and any relevant medical or impairment details.
2. Use a black ink pen to complete the form. Ensure that your handwriting is legible and that you fill in all required fields accurately. Do not leave any blanks unless they are marked as optional.
3. Begin by providing your own information in the designated sections, such as your name, position, and contact details. This information is necessary for the referral process.
4. Move on to the section where you will input the individual's details. Write their name, date of birth, and any other identifying information requested. Double-check for accuracy to avoid any errors.
5. Proceed to the impairment section, where you will describe in detail the nature of the impairment or disabilities the individual is experiencing. Include any relevant medical diagnoses, treatments, and limitations that impact their daily activities or ability to work.
6. If there are any specific accommodations or services the individual requires, clearly outline them in the appropriate section. This may include assistive devices, therapy, or modifications to their environment.
7. Once you have filled out all necessary sections, review the form for any mistakes or omissions. Make sure you have signed and dated the referral form according to the provided instructions.
8. Submit the completed referral form to the appropriate authority or department as instructed. Keep a copy for your records.

Who needs 735-7230 mandatory impairment referral?

1. Individuals who have been diagnosed with impairments, disabilities, or medical conditions that may impact their ability to work or perform daily activities.
2. Employees who require accommodations or services to assist them in their job due to their impairments.
3. Individuals who are seeking access to disability-related benefits, programs, or services that require a referral form as part of the application process.

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What is 735-7230 mandatory impairment referral?

735-7230 mandatory impairment referral is a form used to report individuals who are suspected of being impaired while operating a vehicle.

Who is required to file 735-7230 mandatory impairment referral?

Law enforcement officers and other authorized personnel are required to file the 735-7230 mandatory impairment referral.

How to fill out 735-7230 mandatory impairment referral?

The form should be filled out with detailed information about the impaired individual, the circumstances of the impairment, and any related observations or evidence.

What is the purpose of 735-7230 mandatory impairment referral?

The purpose of the 735-7230 mandatory impairment referral is to ensure that impaired individuals are reported and appropriate actions are taken to ensure public safety.

What information must be reported on 735-7230 mandatory impairment referral?

Information such as the name of the impaired individual, their behavior, any visible signs of impairment, and any relevant circumstances must be reported on the referral form.