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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.

  1. Use the ‘Get Form’ button to access the TX DSHS M-60 form in the online editor.
  2. Begin by filling in the child's name, birthdate, and age in the designated fields at the top of the form.
  3. Under the distance acuity screen section, provide the dates of the first and second screenings and indicate if corrections were made.
  4. For each eye (right and left), enter the results of the distance acuity tests, along with any comments or observations as applicable.
  5. If applicable, specify the type of automated screening device used and report the outcomes under the automated screening device section.
  6. Complete the Hirschberg corneal light reflex test results by selecting pass or fail based on the observations.
  7. Fill out the cover and uncover test results by recording movements and any reasons for referrals if required.
  8. In the screening certification section, provide the screener's signature, printed name, and the date of the screening.
  9. 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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