MD5M has established protocols that MUST be followed when doing Kidsight screenings. Please review the documents below to make sure you are operating in compliance with these protocols.
New? | Revised | Document |
---|---|---|
2018-02 | Screening Protocol | |
2017-09 | Data Entry and Security | |
2020-10-01 | COVID-19 Policies and Procedures | |
2020-10-02 | COVID-19 Liability Waiver Lion | |
2020-10-02 | COVID-19 Liability Waiver Location |
The Word files have places where you fill in information (club name, screening date & location, etc) before printing. The places where you need to insert your information are indicated by blue text. Just click on the blue text, and it will be "selected" so you can type in your information. Then print the number of copies needed.
Clicking on the links will open the Word documents in another window of your browser.
Or use "Right Click" on the link, then choose "Save Link As" to save the file to a folder of your choice.
The PDF files are printable forms with lines where you hand write information.
New? | Revised | Document |
---|---|---|
YES | 2022-03-08 | Letter to Pre-School Director     Word file |
2021-11-29 | Cover Letter to Parents     Word file | |
YES | 2022-06-12 | Cover Letter to Parents - Alternate     Word file   School Director perspective |
YES | 2022-05-24 | Parent Consent Form     Word file |
YES | 2022-06-12 | Results Letter to Parents: Not Referred     Word file |
YES | 2022-06-12 | Results Letter to Parents: Referred     Word file |
YES | 2022-05-24 | Screening Site Worksheet     PDF   Can be used for notes during a screening. |
2021-04 | Photo Release Form - Minor     PDF | |
2021-04 | Photo Release Form - Adult     PDF | |
2019-03 | Vision Screening Information     PDF |
New? | Revised | Document |
---|---|---|
2019-03 | Cover Letter to Parents | |
2021-02-01 | Parent Consent Form | |
2019-03 | Results Letter to Parents: Not Referred | |
2019-03 | Results Letter to Parents: Referred | |
2021-05 | Photo Release Form - Adult |
New? | Revised | Document |
---|---|---|
2019-04 | Cover Letter to Parents | |
2019-04 | Parent Consent Form | |
2019-04 | Results Letter to Parents: Not Referred | |
2019-04 | Results Letter to Parents: Referred |
New? | Revised | Document |
---|---|---|
2019-03 | Cover Letter to Parents | |
2019-03 | Parent Consent Form | |
2019-03 | Results Letter to Parents: Not Referred | |
2019-03 | Results Letter to Parents: Referred |
New? | Revised | Document |
---|---|---|
2021-03 | Cover Letter to Parents | |
2021-03 | Parent Consent Form | |
2021-03 | Results Letter to Parents: Not Referred | |
2021-03 | Results Letter to Parents: Referred | |
2021-03 | Could Not Screen Letter |
These reports are required of all screenings, and are a requirement of our receiving the LCIF and MLVF grants used to purchase equipment. No individually identifiable data is required, but ages and number of children screened is needed, as is follow up status of all children referred for consultation with an eye care professional.
New? | Revised | Document |
---|---|---|
YES | 2022-06-23 | Screening Team Site Report |
Screening Team Site Report Addendum (This report is no longer used). | ||
YES | 2022-06-23 | Screening Follow Up and Indicator Report |
YES | 2022-06 | Screening Follow Up Form (This form is for parents). |
These documents were created by Lion Lori Klein (5M2) for the Plus Optix Camera
New? | Revised | Document |
---|---|---|
2017-08-21 | How To Pre-Enter Data To The Plus Optix Camera | |
2017-08-21 | Sample Spreadsheet for Pre-Entering Data To Plus Optix Camera (.csv file) | |
2017-08-21 | How To Print Referral PDFs From The Plus Optix Camera | |
2017-08-21 | How To Delete Data From The Plus Optix Camera After Screening |
Click on the link to put the file in your Download folder.
Or use "Right Click" on the link above, then choose "Save Link As" to save the file to a folder of your choice.
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