Home
Contact Us
Member Login
Menu
Home
Contact Us
Member Login
About the OOA
Mission and Leadership
Zone Governors
Contact and Staff Information
Follow us on Facebook!
Follow us on Instagram!
Become a Member
Upcoming Events
EVENT CALENDAR
EastWest Eye Conference • October 24-26, 2024
OOA Committee Day • November 13, 2024
REALEYES
Realeyes Program Overview
Request a Presentation
For Presenters
For Schools
Community Resources
@RealeyesProgram
@RealeyesProgram
Public Resources
Public Resources Overview
Ohio Optometric Foundation
Helpful Patient Resources
Optometry Cares
InfantSEE Program
Ohio Amblyope Registry
Order Vision Simulator Cards
Contribute to OOPAC
Member Login
OOA News • PERSPECTIVES
Member Advantages
Member Options & Dues Info
Young OD Community
OOPAC
Third Party Payer Issues
Ohio Diabetic Eye Alliance
Classifieds
OOA Documents
View Member Profile
AOA Excel
iSee Clinic Request
Thank you for your interest in hosting the Ohio Optometric Foundation’s (OOF) In School Eye Exam (iSee) program. Completion of this form is necessary for the OOF to determine need and capacity to deliver the iSee program to your school.
School Information
School Name:
City:
County:
School District:
Primary Contact
First Name:
Last Name:
Position:
Phone:
Email:
School Information
School Enrollment #s:
% of students on IEP:
% of students receiving free and reduced lunch:
Most recent school vision screening:
?
# of students screened:
# of students referred for eye exam:
# of students not receiving follow-up care:
Scheduling Timing
School start time:
School end time:
First choice dates:
Second choice dates:
Third choice dates:
- denotes required fields
Next >