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USED Affiliates
Preschool Vision Screening Request Form
I am interested in having the Jules Stein Eye Institute (USED) Affiliates conduct a Preschool
Vision Screening (PSV) test for my preschool students.
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How to fill out preschool vision screening request

How to fill out preschool vision screening request
01
Start by downloading the preschool vision screening request form from the official website.
02
Fill out the contact information section accurately, including your name, address, and phone number.
03
Provide the necessary information about your child, including their name, date of birth, and current school or daycare.
04
Indicate whether your child has had any previous vision screenings or eye exams.
05
Specify the preferred time and date for the vision screening, if applicable.
06
Sign the form at the designated area to confirm your consent for the vision screening.
07
Double-check all the information provided to ensure accuracy and completeness.
08
Submit the filled-out form to the designated authority or organization responsible for preschool vision screenings.
09
Follow any additional instructions or requirements provided by the authority for further processing.
Who needs preschool vision screening request?
01
Preschool vision screening requests are needed by parents or legal guardians of children who are attending or about to enroll in preschool, daycare, or similar educational programs. These requests help identify potential vision problems in young children and facilitate early intervention and treatment if necessary.
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What is preschool vision screening request?
A preschool vision screening request is a formal application submitted to ensure that young children receive an evaluation of their vision to identify any potential issues that may affect their development and learning.
Who is required to file preschool vision screening request?
Parents or guardians of preschool-aged children are typically required to file the preschool vision screening request to ensure the child's vision is properly assessed.
How to fill out preschool vision screening request?
To fill out the preschool vision screening request, gather the required information such as the child's name, date of birth, and any relevant medical history, and complete the designated form with accurate details before submission.
What is the purpose of preschool vision screening request?
The purpose of the preschool vision screening request is to identify and address any vision problems early, which can help facilitate better learning and development for young children.
What information must be reported on preschool vision screening request?
The information that must be reported on a preschool vision screening request typically includes the child's personal information, medical history related to vision, and details of any previous vision screenings.
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