A person with a central visual acuity disability shall submit an application on a form provided by the Department. The application shall be completed in full and shall bear the applicant's name, address and signature. The application shall also bear the printed name, address and signature of the individual licensed to practice medicine that certifies the applicant meets the qualifications of a person with a central visual acuity disability as specified in this Section 3. Central Visual Acuity Disability Permits shall be issued to qualified applicants by the Department's License Section, Regional Offices or designated Department personnel.
040-64 Wyo. Code R. § 64-5