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Form HSMV77066 Ignition Interlock Medical Evaluation Form - Florida
What Is Form HSMV77066?
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 the Form HSMV77066?
A: The Form HSMV77066 is the Ignition Interlock Medical Evaluation Form in Florida.
Q: What is the purpose of the Form HSMV77066?
A: The purpose of the Form HSMV77066 is to evaluate an individual's medical condition and determine their eligibility for an ignition interlock device in Florida.
Q: Who needs to fill out the Form HSMV77066?
A: The Form HSMV77066 needs to be filled out by individuals who are required to install an ignition interlock device in their vehicle due to a DUI or other alcohol-related offense in Florida.
Q: Are there any fees associated with the Form HSMV77066?
A: There are no fees associated with the Form HSMV77066. However, there may be fees associated with the ignition interlock program and device installation.
Q: Do I need to submit the Form HSMV77066 along with my application?
A: Yes, you will need to submit the completed Form HSMV77066 along with your ignition interlock device application to the Florida DHSMV.
Q: Who can help me fill out the Form HSMV77066?
A: You can consult with your healthcare provider to help you fill out the Form HSMV77066 accurately and provide the necessary medical information.
Form Details:
- Released on June 1, 2011;
- 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 HSMV77066 by clicking the link below or browse more documents and templates provided by the Florida Department of Highway Safety and Motor Vehicles.
