Get Functional Vision And Hearing Form

Filling out the Functional Vision And Hearing Form online is an essential step in assessing whether a child's functional vision and hearing are adequate for further evaluation. This guide will provide you with clear, step-by-step instructions to navigate the form efficiently and accurately.

Follow the steps to complete the form online.

1. Click ‘Get Form’ button to access the form and open it in the document editor.
2. Enter the child's name in the designated field provided at the top of the form.
3. Input the referring person's name in the appropriate section next to 'Referring Person'.
4. Fill in the child's date of birth by selecting the correct date from the calendar or entering it manually in the specified format.
5. In the vision section, review the checklist of behaviors. Indicate the child's functional vision by checking all applicable boxes that reflect their abilities.
6. Similar to the vision section, assess the child’s hearing. Check all statements that apply to the child's hearing capabilities from the provided checklist.
7. Once the form is fully completed, ensure that the evaluator's signature and title are filled in at the bottom of the form.
8. Finally, review all the information for accuracy. Save the changes, and you may choose to download, print, or share the completed form as needed.

Complete the Functional Vision And Hearing Form online today to ensure timely assessment for your child.