Prevent Blindness Georgia
     
Permission Forms


Note: Use the Flashpaper printer icon to print these forms.


Permission Forms for a PBGA Children's Vision Screening

If parent does not return letter child will be screened.

English

Spanish


If parent does not return letter child will not be screened.

English

Spanish

If you are scheduled for a screening and need an emergency permission form,
please call 404.266.1548 to confirm your screening, then print the
appropriate permission letter.


PBGA Sample Children's Vision Screening Results Letters

Incomplete English
Incomplete Spanish

 


PBGA Sample Children's Vision Screening Registration Form

English



Permission Form for a School Nurse Children's Vision Screening

English


Happy Feet

Click to download full size.



 

 

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