Sample Forms

Downloadable Consent Forms

Colorado Consent ENGLISH General (Rev 7-14) ~ PDF Document
Colorado Consent SPANISH General (Rev 7-14) ~ PDF Document
Connecticut Consent Forms 2014-15 English ~ PDF Document
Connecticut Consent Forms 2014-15 Spanish ~ PDF Document
Indiana Consent Form ~ PDF Document 
Iowa MTI Consent Form~ PDF Document
Iowa Screening Consent Form Iowa KidSight ~ PDF Document
New York Screening Consent Form SPANISH – PDF Document
Tennessee Consent form ~ PDF Document

Downloadable Referral/screening Results Forms

Alaska Refer letter ~ PDF Document
Colorado Vision Screening results (Rev 7-13) ~ PDF Document
Connecticut Refer letter ~ PDF Document
Indiana KidSight screening results ~ PDF Document
New York screening results – PDF Document

Miscellaneous Downloadable Forms

Physician Evaluation Sheet English (Rev 6-14) ~ PDF Document
Why Vision Screening English ~ PDF Document
Why Vision Screening Spanish ~ PDF Document
Memorandum of Understanding ~ PDF Document
New York Letter to Eye Care Professional – PDF Document
Connecticut Pass letter ~ PDF Document
Sample Letter to Preschool, Nursery or Daycare ~ PDF Document
Indiana KidSight Evaluation Sheet ~ PDF Document