Schedule a Vision Screening
Request a Screening
We are delighted that you are interested in requesting a screening! Please follow the steps below to complete the form:
Access the Form: Click on the link below to open the screening request form. This will take you directly to the online form. Request A Screening
Provide Your Details: Once the form opens, please fill in the required information:
Organization Name
Contact Name
Phone Number
Email Address
Best Time to Contact
Is This Request for One Site or Multiple Sites?
Anticipated Number of Children Screened?
Information Regarding Specific Date/Time Requests
Submit the Form: After filling out all the required fields, click the "Submit" button at the bottom of the form.
Confirmation: You will receive a confirmation email once your request has been submitted successfully. If you do not receive this email within 24 hours, please check your spam/junk folder or contact us at [contact email].
Thank you for taking the time to request a screening. We look forward to working with you!
Forms
To better track the paperwork movement, please complete the Kidsight Mail Tracker form if you are mailing items and the Kidsight Cover Sheet. Kidsight Mail Tracker Form