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  • Ms Gulfport School District Hearing/vision Screening Report 2015

Get Ms Gulfport School District Hearing/vision Screening Report 2015-2025

SMENT A. HEARING SCREENING Instrument: st 1 Screening L Ear 1000 Hz / 25 dB R Ear L Ear 2000 Hz / 25 dB R Ear L Ear 4000 Hz / 25 dB R Ear Optional: L Ear R Ear PASS Hearing FAIL EXAMINER DATE B. VISION SCREENING Instrument: nd 2 Screening L Ear R Ear L Ear R Ear L Ear R Ear L Ear R Ear PASS FAIL st 1 Screening YES Screened wearing glasses? NO PASS Near Vision (Both Eyes) FAIL / Far Vision Left Eye Right Eye / Both Eyes / PASS FAIL nd 2 Screening YES NO PASS FAIL / / / PASS FAIL EXAMINER D.

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How to fill out the MS Gulfport School District Hearing/Vision Screening Report online

The MS Gulfport School District Hearing/Vision Screening Report is a vital document used to assess a child's hearing and vision capabilities. This guide offers clear steps on how to complete the report online for a seamless experience.

Follow the steps to successfully fill out the screening report.

  1. Press the ‘Get Form’ button to access the document and open it in the editor.
  2. Enter the child’s personal data in the designated fields, including their name, race/ethnicity, district/school, MSIS number, gender, date of birth, grade, and age.
  3. Proceed to Part I – Instrumental Assessment. In the Hearing Screening section, specify the instrument used and fill out the screening details for both left and right ears at the specified frequencies. Indicate whether the child passed or failed the hearing test.
  4. Continue with the Vision Screening section under Part I. Note the instrument used, then fill in the necessary details for near and far vision for both eyes. Also indicate if the child was screened with glasses and whether they passed or failed the vision test.
  5. Move to Part II – Functional Assessment. For hearing, respond to each question with 'yes' or 'no' based on your understanding of the child’s abilities. Provide an assessment by checking the appropriate box.
  6. For the vision assessment, similarly respond with 'yes' or 'no' to each question regarding the child’s visual behaviors.
  7. In the final section, describe any additional behaviors related to hearing and vision that should be taken into consideration for assessment and educational programming.
  8. After completing all sections, save the changes, then download, print, or share the form as needed.

Complete the MS Gulfport School District Hearing/Vision Screening Report online today for a thorough assessment of your child's needs.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232