Vision Screening Forms & Materials
Forms
The following forms are available as printable PDFs
- Child Vision History Questionnaire for Parent/ Caregiver (PDF) Reviewed 7/2018
- Teacher and Child Vision Pre-Screening Worksheet (PDF) Reviewed 7/2018
- Vision Screening Worksheet (PDF) Revised 1/2019
- Vision Referral Letter (PDF) Revised 10/2019
- Color Vision Advisory Letter (Word) Reviewed 2/2020
Training Manual for Printing
Child and Teen Checkups
- Child and Teen Checkups Periodicity Schedule (PDF)
- Hearing and Vision: Screener Checklist (PDF) Revised 2/2020
- Vision Screening Fact Sheet (PDF) Revised 4/2021
- Quick Reference Hearing and Vision Screening (PDF) Revised 7/2020
