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It is important that the Medical Report Form be. Anyone requesting that a driver be medically evaluated must complete and sign the Request for Medical Evaluation form.While we cannot complete DMV Medical Forms, we can provide a driver evaluation to aid your doctor in completing these forms. Address. We generally consider a completed Form I693 to remain valid for 2 years after the date the civil surgeon signed Form I693. Items 1 - 17 — (Physical Examination) of the CG 719K DO NOT have to be completed. What is the legal basis for requesting medical information for visa applicants? TO BE COMPLETED BY APPROPRIATE MEDICAL OR PARAMEDICAL PROFESSIONAL (Clinician). 1. Driver must complete this section, but medical examiner is encouraged to discuss with driver. Yes. I HEREBY CERTIFY THAT THIS REPORT OF MEDICAL EVALUATION is complete and accurate and complies with the Texas Workers'. ✓ need to lift children.