Kansas DMV Vision Form (DV-124V): Filing, Standards, Restrictions

The Kansas DMV vision form DV-124V is the vision report an optometrist or ophthalmologist completes to tell the Division of Vehicles about your acuity, peripheral field, and any eye condition that affects driving. You need it when you fail the eye screening at a license office or when the Division writes to request updated vision information. The completed form goes to the Medical/Vision Unit in Topeka, and the exam has to be no more than 90 days old when the Unit receives it.¹

When You Need the Form

Two things trigger it. The first is failing the in-office screening. Under K.S.A. 8-295, if you cannot read the 20/40 line with at least one eye, the examiner hands you a blank DV-124V and sends you to an eye doctor of your choosing.² The second is a letter from the Division of Vehicles asking for a current vision report. That letter gives you 30 days to get the exam done and return the paperwork, and the Department’s FAQ page is direct about the consequence: driving privileges are revoked when required forms are not submitted or come in incomplete.³

You can download a blank form at ksrevenue.gov or pick one up at any driver’s license office.¹

Filling Out Your Section

The patient section at the top asks for your full legal name, Kansas driver’s license number, date of birth, mailing address with city, state, and ZIP, and a phone number. If you are enrolled in driver’s education, mark “Yes” and give the instructor’s name and phone. Sign and date the release-of-information line. If you are under 18, a parent or guardian signs instead.¹

What Your Eye Doctor Completes

Section I is the Vision Report, filled out by your optometrist or ophthalmologist. They record:¹

Distance acuity for each eye, tested with and without corrective lenses, written as a 20/ notation.
Bioptic or telescopic acuity for each eye if applicable.
Horizontal field of vision in degrees for each eye.
The vision condition, its diagnosis, and its expected prognosis.
Yes/no clinical recommendations covering adaptive equipment, drive test, medical exam, and Medical Advisory Board review.
Any Cortical Visual Impairment testing results, printed and attached.

The provider then signs, dates, and prints their name, specialty, address, and phone. The exam date on the form must fall within 90 days of when the Medical/Vision Unit receives it. A stale form means a new appointment.³

Vision Standards You Have to Meet

If you test 20/40 or better in at least one eye at the office, you pass the screening and no DV-124V is required. Once an eye doctor examines you and fills out the form, you need at least 20/60 in your better eye, with or without correction, to be eligible for a license.² At exactly 20/60 in the better eye, the examiner will also require a driving test. Below 20/60, a license is still possible under K.S.A. 8-295(d) if you can show safe operation of a vehicle and a clean driving record for the previous three years, and the Division can attach reasonable restrictions.⁴

Restrictions a Provider Can Recommend

The bottom of the form lists specific restrictions your doctor can suggest, up to six at once:¹

Corrective lenses while driving.
Daylight hours only.
No interstate driving.
Outside business area.
Within city limits.
Licensed driver in the front seat.
Automatic transmission only.
Outside mirror on both sides.
Mechanical or prosthetic aid.
A radius of 5 to 30 miles from your home, in five-mile increments.

These are recommendations, not final decisions. The Medical/Vision Unit, and in complex cases the Medical Advisory Board, decide what actually goes on your license.⁵

Where to Send the Form

Mail or fax the completed DV-124V to the Medical/Vision Unit:

State of Kansas Director of Vehicles
Medical/Vision Unit
300 SW 29th St.
P.O. Box 12021
Topeka, KS 66601-2021¹

Fax: (785) 296-5857. Phone for questions: (785) 368-8971.⁵ If the Division sent you a request letter, you have 30 days from that letter to get the form back. Missing the deadline leads to revocation, and reinstatement requires completing the form and going through the full review.³

What Happens After Submission

The Medical/Vision Unit uses your provider’s findings to decide whether you get an unrestricted license, a restricted license, or no license. The Department’s FAQ describes the review window as roughly 30 days.³ Watch your mail for a decision letter or an updated license card.

Harder cases go to the Kansas Medical Advisory Board, which can require a Driving Rehabilitation Assessment with a provider you choose before making a recommendation to the Director.⁶ If you disagree with the outcome, K.S.A. 8-295(e) entitles you to a hearing under K.S.A. 8-255(c).² Request one by calling the Administrative Hearing Section at (785) 296-6911 or writing to DL Administrative Hearing Section, Kansas Department of Revenue, P.O. Box 2744, Topeka, KS 66601-2744.⁷

Driving With Bioptic Telescopic Lenses

Kansas allows driving with bioptic telescopic lenses, and the form has dedicated acuity fields for them. Your carrier acuity, meaning the view through the regular lens rather than the telescope, must be 20/400 or better. The drive test is based on carrier-lens acuity, and your doctor has to certify you are safe enough to attempt it. Bioptic drivers submit a vision report annually so the Division can track the condition.¹

Removing a Corrective Lens Restriction After LASIK

If surgery has brought you to 20/40 or better without glasses, you can have the “Corrective Lenses” restriction taken off. Your eye doctor completes a DV-124V confirming the corrected acuity and that you are fully healed, and you submit it to the Medical/Vision Unit the same way. Once processed and approved, your updated license drops the restriction.⁵

1
Kansas Department of Revenue. Kansas Division of Vehicles Vision Form
2
Justia. Kansas Code 8-295 – Vision Standards for Drivers Licenses
3
Kansas Department of Revenue. Division of Vehicles – Medical / Vision Frequently Asked Questions
4
Kansas Legislature. 2026 Kansas Statutes 8-295
5
Kansas Department of Revenue. Medical/Vision Review Information
6
Kansas Department of Revenue. Medical / Vision Unit
7
Kansas Department of Revenue. Administrative Hearing Information