Vision Screening Referral Letter for Children: Eye Care Guidance 2025

1. Click ‘Get Form’ to open the Vision Screening Referral Letter in the editor.
2. Begin by entering the child's name and date of birth at the top of the form. This information is crucial for identifying the child during their eye examination.
3. In the section detailing screening results, fill in the right and left eye vision scores as indicated. If your child had difficulty reading lines on the chart, make sure to note that clearly.
4. If applicable, provide any observations regarding your child's eye appearance or complaints about vision difficulties. This helps the eye care professional understand potential issues.
5. The health care provider will need to complete their section after examining your child. Ensure they fill in their findings accurately, including any recommendations for follow-up care.
6. Finally, ensure that all sections are completed before returning this form to school staff or directly to your child's eye care professional.

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