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:

1. 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

2. 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

3. Submit the Form: After filling out all the required fields, click the "Submit" button at the bottom of the form.

4. 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!