
Flush leftCertificate of Record for Vision Screen and/or Eye Examination Certificate of Record for Vision Screen and/or Eye Examination Child 's Name Birthdate Age Child 's Name Birthdate Age Flush.
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How to fill out the TX DSHS M-60 online
The TX DSHS M-60 form is essential for documenting a child's vision screening or eye examination. This guide will provide step-by-step instructions to assist users in completing the form online with ease and accuracy.
Follow the steps to successfully complete the TX DSHS M-60 online.
- Use the ‘Get Form’ button to access the TX DSHS M-60 form in the online editor.
- Begin by filling in the child's name, birthdate, and age in the designated fields at the top of the form.
- Under the distance acuity screen section, provide the dates of the first and second screenings and indicate if corrections were made.
- For each eye (right and left), enter the results of the distance acuity tests, along with any comments or observations as applicable.
- If applicable, specify the type of automated screening device used and report the outcomes under the automated screening device section.
- Complete the Hirschberg corneal light reflex test results by selecting pass or fail based on the observations.
- Fill out the cover and uncover test results by recording movements and any reasons for referrals if required.
- In the screening certification section, provide the screener's signature, printed name, and the date of the screening.
- Finally, review all the entered information for accuracy before proceeding to save changes, download, print, or share the completed form.
Start completing the TX DSHS M-60 online today to ensure timely submission.
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