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MEDICAL HISTORY NAME DATE INSURANCE REFERRED BY PRIMARY CARE MD LAST EYE EXAM OPTOMETRIST/ OPTICIAN PAST EYE HISTORY EYE SURGERY/ LASER YES/NO SOCIAL HISTORY Does your vision limit any activities
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How to fill out vision exam vs medical

01
To fill out a vision exam, follow these steps:
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Start by providing your personal information such as your name, age, and contact details.
03
Answer any questions regarding your medical history, including any past eye surgeries or conditions you may have.
04
Proceed to the vision test section, which typically involves reading letters or identifying images at varying distances.
05
If you wear prescription glasses or contact lenses, make sure to mention it and bring them along for the exam.
06
Follow any additional instructions given by the examiner, such as covering one eye or performing specific tests.
07
Once you have completed all the necessary sections, review your answers and ensure accuracy.
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Sign and date the vision exam form, and submit it as instructed by the examiner.

Who needs vision exam vs medical?

01
A vision exam is typically needed by individuals who:
02
- Are experiencing vision problems such as blurred vision, eye strain, or difficulty seeing.
03
- Want to get a new pair of prescription glasses or contact lenses.
04
- Require an evaluation for potential eye diseases or conditions.
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- Have a family history of eye disorders and want to assess their own eye health.
06
On the other hand, a medical exam is necessary for:
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- Individuals seeking overall health evaluation, including blood pressure, heart rate, and general physical well-being.
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- Those in need of medical clearances for specific activities or jobs.
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- Individuals with existing medical conditions who require routine check-ups and monitoring.
10
- Anyone looking to assess their overall health status and identify potential health risks.
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A vision exam is specifically focused on assessing visual acuity, eye health, and vision-related issues, while a medical examination typically encompasses a broader assessment of overall health, including physical examinations and evaluations of other health conditions.
Individuals who operate specific types of vehicles or machinery, such as commercial drivers, may be required to file both vision and medical examinations, as mandated by regulatory authorities.
To fill out a vision exam, one typically needs to provide their personal information, the results of the eye tests, and a signature from the eye care professional. For a medical exam, the individual must complete a health history questionnaire along with documentation of the medical assessment results.
The purpose of a vision exam is to ensure that individuals meet the visual standards required for safe driving or machine operation, while a medical exam assesses overall health and potential medical conditions affecting fitness for duty.
Vision exams must report visual acuity results, findings related to eye health, and any corrective measures required, while medical exams must include health history, vital signs, and results from any necessary diagnostic tests.
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