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Functional Vision Screening Form - Tuscaloosa County Schools

Functional Vision Screening Form - Tuscaloosa County Schools 2025

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The document is a Functional Vision Screening Form used by Tuscaloosa County Schools to assess students' visual capabilities. It includes sections for student and parent information, a series of yes/no questions regarding visual responses, and observations related to eye function. The form is designed to identify any potential vision issues in students.

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Click ‘Get Form’ to open the Functional Vision Screening Form in the editor.
Begin by entering the student’s name, school, and grade in the designated fields at the top of the form.
Next, fill in the parent(s)’ name and address to ensure proper contact information is recorded.
For each observation section, mark 'YES' or 'NO' based on your assessment of the student's visual capabilities.
In the observations section, provide detailed notes for each item listed, such as pupillary reaction and gaze tracking. Use clear descriptions for actions taken.
Finally, complete the 'Action Taken' field and sign off with your name and date to finalize the screening process.

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