Get E12s Form

The E12s Form is a crucial document for reporting vision screening results for students. This guide provides a detailed, step-by-step approach on how to accurately fill out the form online, ensuring all necessary information is reported effectively.

Follow the steps to complete the E12s Form with ease.

1. Click ‘Get Form’ button to access the E12s Form and open it in the editor.
2. Begin by entering the child's last name, first name, and date of birth in the designated fields.
3. Indicate the child's gender by selecting either 'Male' or 'Female'.
4. Fill in the district borough, grade/class, and school information.
5. Complete the screening results section by specifying the results for far and near vision, indicating whether each test was passed or failed.
6. If the child did not pass the color screening, confirm the color deficiency by selecting 'Yes' or 'No'.
7. Provide the eye doctor's examination details, including the date, diagnosis, and any prescribed treatments or recommendations.
8. Indicate if glasses or contact lenses are recommended, and specify when they should be worn.
9. Include any additional notes regarding special vision services, school accommodations, or further testing that may be necessary.
10. Lastly, save your changes, download, print, or share the completed form as needed.

Complete the E12s Form online today to ensure your child's vision needs are properly addressed.