Get the free B-3 vision screening-rescreen form - comaction

East Central Illinois Community Action Agency Birth to Three Vision Screening’Re screen Form Teacher’s) Center: Child's Name DOB Test Date screening or prescreen L. Eye Follows red yarn past midline

How to fill out b-3 vision screening-rescreen form

How to fill out a b-3 vision screening-rescreen form:

1. Start by carefully reading the instructions on the form. Make sure you understand what information is required and how it should be filled out.
2. Fill out the personal information section at the top of the form. This may include the patient's name, date of birth, contact information, and any other details requested.
3. Next, provide the details of the person conducting the screening-rescreen. Include their name, credentials, and any additional information as requested.
4. Move on to the vision screening results section. Follow the instructions provided to record the findings of the vision screening, including visual acuity and any abnormalities or noted observations.
5. If a rescreen is required, indicate the reason for the rescreen and any additional information related to the previous screening or follow-up instructions.
6. Finally, sign and date the form. Ensure that all necessary signatures are obtained, including those of the person conducting the screening, the patient (or their legal guardian), and any other required individuals.
7. Review the completed form for any errors or omissions before submitting it to the appropriate authority or keeping it on record.

Who needs a b-3 vision screening-rescreen form:

1. School districts: In many jurisdictions, school districts require students to undergo vision screening to ensure they have optimal vision for learning and overall well-being. The b-3 vision screening-rescreen form may be used to document the results of these screenings and any subsequent rescreens.
2. Healthcare providers: Pediatricians, ophthalmologists, optometrists, and other healthcare professionals who regularly perform vision screenings may utilize the b-3 vision screening-rescreen form to document and monitor their patients' visual health.
3. Government agencies: Some government agencies or programs may require vision screenings as part of their services or eligibility criteria. These agencies may use the b-3 vision screening-rescreen form to collect and assess the vision screening data of individuals within their jurisdiction.

Overall, anyone responsible for conducting vision screenings and ensuring the accuracy and completeness of the screening results may need to use the b-3 vision screening-rescreen form. It serves as an important document for tracking and monitoring vision health.

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