How to Fill Out Kentucky Form TC 94-202: Vision Testing Certification

Kentucky Form TC 94-202, the Driver Vision Testing Certification, is the document a licensed vision specialist or a KYTC-credentialed medical professional completes to certify that you meet the state’s eyesight standards for a driver’s license. You fill in the top portion with your identifying information, your provider records the clinical results and signs the certification, and the completed form is then either carried by you to a Driver Licensing Regional Office or sent by the provider directly to Frankfort, depending on the outcome. The blank form is available as a PDF from the Kentucky Transportation Cabinet’s forms library, and most providers who handle these exams have copies on hand.

When You’ll Be Handed This Form

Every applicant for an initial instruction permit, initial operator’s license, renewal, or reinstatement in Kentucky must pass a vision test.¹ The TC 94-202 comes into play whenever that test happens somewhere other than a Driver Licensing Regional Office. Four situations are typical:

You failed the wall-chart screening at a regional office and were referred to a vision specialist for a full exam.²
You’d rather have a private provider do your renewal screening than take the free one at a regional office. If you pass, the provider gives you the completed form to bring in with your renewal.³
You’re renewing online. Starting January 1, 2025, a completed TC 94-202 serves as your vision screening proof for online renewals.³
The Medical Review Board has ordered an exam because a law enforcement officer, physician, or the Transportation Cabinet flagged a possible vision impairment.⁴

A separate Bioptic Driving Program exists for drivers whose acuity is too low for a standard license but who can drive safely with a telescopic device on their glasses; that program has its own rules and doesn’t use the TC 94-202 for licensing under 601 KAR 12:120.⁵

Who Is Allowed to Sign the Form

Only two categories of professionals can validly complete and sign the TC 94-202:⁶

Vision specialists, meaning optometrists licensed under KRS Chapter 320 (or an out-of-state equivalent) and ophthalmologists licensed under KRS Chapter 311. These providers need no additional KYTC credential.²
KYTC Credentialed Medical Specialists, meaning osteopaths, physicians, or advanced practice registered nurses who have completed the Medical Specialist Credentialing Certification (Form TC 94-203) and been approved by the Division of Driver Licensing.²

One important distinction: if you were referred because you failed the in-office screening, only a vision specialist can perform the follow-up exam. A credentialed nurse practitioner or family physician can handle a routine renewal screening but cannot clear a referral case.² The Transportation Cabinet publishes a list of approved credentialed medical specialists on its medical providers page.

Filling Out Each Section

The form has three sections. You handle the first. Your provider handles the other two.

Section 1: Driver and Applicant Information

Enter your last, first, and middle name exactly as they appear on your license or permit. Provide either your Kentucky driver’s license number or your Social Security number; the form accepts either. Add your date of birth.⁶ Check these entries carefully before handing the form to your provider. A nickname, an outdated name after a legal change, or a transposed digit can keep the state from matching the results to your driving record.

Section 2: Vision Examination Results

Your provider records the clinical findings. The form captures visual acuity for the left eye, the right eye, and both eyes together, both with and without corrective lenses. It also captures horizontal and vertical field-of-vision measurements. If corrective lenses are prescribed and that restriction isn’t already on your license, it will be added when the license is issued.³ Results should be written in standard Snellen notation (like 20/40) and in full degree measurements without abbreviations.

Section 3: Medical Professional Certification

The provider checks a box identifying themselves as a vision specialist or a KYTC Credentialed Medical Specialist, then fills in their full name, title, office address, phone number, medical or optometry license number, and the state that issued it. They sign and date the form to certify that the results are accurate.⁶ An unsigned certification will be rejected, and an illegible exam date can trigger a request for a new exam.

The Standards Your Results Are Measured Against

You’ll want to read your own numbers on the form and understand where they land. Kentucky uses a tiered acuity standard:⁵

20/40 or better in one eye without corrective lenses: you pass with no license restrictions.
20/40 or better in one eye with corrective lenses: you pass, but your license carries a corrective-lens restriction.
Worse than 20/40 but 20/60 or better in one eye: you don’t pass the office screening, but a vision specialist can still certify you if you meet the field-of-vision standard; corrective lenses are required if prescribed.
Worse than 20/60 in your better eye: you do not meet the minimum for a standard license.

For the field of vision, the regulation requires at least 30 degrees to the left and right of fixation and at least 25 degrees above and below fixation in your better eye.⁵

Where the Completed Form Goes

Routing depends on the result. This is the step people most often get wrong.

If You Passed

You keep the form. Bring it with you to a Driver Licensing Regional Office when you apply, renew, or reinstate, or upload it through the online renewal portal if you’re renewing online.⁶ Without it, the office cannot process your transaction.

If You Did Not Meet the Standards

Your provider sends the form directly to the Division of Driver Licensing. You don’t carry it in yourself.⁶ The address is:

Transportation Cabinet
Division of Driver Licensing
200 Mero Street
Frankfort, KY 40601-1920
Email: kytc.ddlvision@ky.gov⁶

If the Medical Review Board Ordered the Exam

A copy of the completed form must reach the Board within 20 days of the exam date. It can be sent by mail, email, or fax:⁶

Medical Review Board
200 Mero Street
Frankfort, KY 40601-1920
Email: KYTC.MedicalReviewBoard@ky.gov
Phone: (502) 564-1257
Fax: (844) 503-4111

Keep a personal copy of whatever you or your provider submits. A lost envelope or a failed fax is far less painful when you can produce your own copy instead of scheduling another exam.

What Happens Next

If you passed and brought the form to a regional office, the clerk verifies it, processes your license, and adds any corrective-lens restriction the provider indicated. Online renewals are processed the same way once the form is reviewed.

When results below the passing standard reach the Division of Driver Licensing or the Medical Review Board, the Board reviews the clinical findings against the statutory thresholds and sends you a written decision by mail. Possible outcomes:

Clearance with restrictions, such as mandatory corrective lenses or a scheduled re-evaluation if your condition is progressive.
Denial or suspension, typically when acuity falls below 20/60 in both eyes or the field of vision doesn’t meet the minimum.
A request for additional documentation or a follow-up exam when the initial results are borderline.

If your provider tells you your acuity is too low for a standard license, ask about the Bioptic Driving Program before assuming you can’t drive at all. Drivers licensed under KRS 186.579 through that program are restricted to the use of the bioptic device and are handled separately from the standard vision-testing rules.⁵⁷

Common Reasons Forms Get Rejected

Most problems are preventable. The recurring ones:

Wrong provider type. A referral after a failed office screening requires a vision specialist, not a credentialed medical specialist.
Missing signature or date in Section 3. The certification is not valid without them.
Name or ID mismatch between the form and your driving record.
Stale results. Submit the form promptly after your appointment or you may be asked to repeat the exam.
Wrong destination. A passing form goes with you to a regional office or through the online portal. A failing form goes directly from your provider to Frankfort. Mixing these up delays everything.

1
Kentucky Legislative Research Commission. Kentucky Revised Statutes 186.577 – Testing Applicants for Initial Operator’s License or Initial Instruction Permit
2
Kentucky Transportation Cabinet. Information for Vision Specialists and Medical Providers
3
Kentucky Transportation Cabinet. Vision Screening Fact Sheet
4
Cornell Law Institute. Kentucky Code 601 KAR 13-090 – Medical Review Board; Basis for Examination, Evaluation, Tests
5
Kentucky Legislative Research Commission. Kentucky Administrative Regulations 601 KAR 12:120 – Vision Testing
6
Kentucky Transportation Cabinet. Driver Vision Testing Certification Form TC 94-202
7
Kentucky Career Center. Bioptic Driving Program