Home
Contact Us
Member Login
Menu
Home
Contact Us
Member Login
About the OOA
Mission and Leadership
Contact and Staff Information
Follow us on Facebook!
Become a Member
Upcoming Events
EVENT CALENDAR
Optometry Day at the Statehouse • May 17, 2023
OOF Annual Golf Outing • August 2, 2023
EastWest Eye Conference • November 1-4, 2023
REALEYES
Realeyes Program Overview
Request a Presentation
For Presenters
For Schools
@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 CENTER
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
COVID-19 MEMBER RESOURCES
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 disadvantaged:
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 >