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Vision screening results form 2026

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  1. Click ‘Get Form’ to open the vision screening results form in the editor.
  2. Begin by entering the student's name, date, room number, teacher's name, and school in the designated fields. This information is crucial for identifying the student.
  3. Indicate the student's gender and age, along with their grade and doctor's name. These details help provide context for the screening results.
  4. Specify whether the student wears glasses or contacts by selecting 'YES' or 'NO'. This can impact their vision assessment.
  5. Choose whether the screening was conducted with or without corrective lenses by circling the appropriate option.
  6. Fill in the distance vision results for both right and left eyes using the provided scale. Ensure accuracy as this is vital for further evaluation.
  7. Complete sections on binocular vision and refractive error by entering measurements as indicated. Pay attention to detail to ensure correct data entry.
  8. Finally, document color vision results and any comments regarding pass/fail status or recommendations for follow-up exams.

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