RESOURCES FOR VISION SCREENERS

The letters and forms below are electronic versions of the documents provided in the Vision Screening Requirements and Guidelines for Preschool and School-Aged Children 2017 published by the Ohio Department of Health. You may download and reproduce any or all of these forms to use for your screenings and follow up. 

All letters are in Microsoft Word format. They can be edited to include school or office name, logos and other important information.  Letters A, B, C, and E which are referenced with an asterisk (*) have been translated into Arabic, Chinese, Dutch, French, German, Italian, Russian, Somali, Spanish and Ukrainian. The translated versions can be downloaded on the ODH website. Click here to access the translated letters.

Most forms are in PDF format. The forms with an asterisk (*) are provided in

Microsoft Excel format. Student information can be easily downloaded into

the Excel Spreadsheets for ease of recording.

These two documents are not included in the Vision Screening Requirements and Guidelines for Preschool and School-Aged Children 2017. Screeners may find them helpful summaries of the referral criteria and resources that are available to assist with eye exams, glasses, and many other vision resources.

LETTERS
FORMS
RESOURCES

© 2016 by Prevent Blindness, Ohio Affiliate

This work is funded either in whole or in part by a grant awarded by the Ohio Department of Health, Bureau of Maternal, Child and Family Health, Save Our Sight and as a sub-award of a grant issued by The Ohio Department of Health under the Save Our Sight Program.