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Certification of Licensed Driving Experience
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CERTIFICATION OF LICENSED DRIVING EXPERIENCE
We have updated our guidelines for drivers with an MVR that does not show 4 or more years of licensed driving experience. If we cannot obtain an MVR showing original issue date of license, we now require a statement signed by the driver confirming the month/year they were first licensed.
Driver Name
First
Last
Date First Licensed
MM slash DD slash YYYY
Driver Signature:
I certify that the above information is accurate to the best of my knowledge.
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About
Mission
Vision
Values
Meet The Team
Leadership
Careers
Services
Urgent Care
Routine Check-Ups
Acute Illness Treatment
Minor Injuries
Health Education & Counseling
Women’s Health Services
Men’s Health Services
Preventive Care
Treatment Programs
Resources
Admissions
Contact
Insurance Coverage
New Patient Intake
In-Network Health Plans
Locations
Cincinnati
Chillicothe
Cleveland
Columbus
Dayton
Norwood
Sidney
Service Areas
Columbus
Dublin
Gahanna
Grove City
Hilliard
Huber Heights
Massillon
Reynoldsburg
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