IEP Eye Exam Report

A standard report form has been created for use by doctors following an IEP Eye Exam. A copy of the form is available below in Miscrosoft Word format.

Download the Eye Exam Report for IEP

After conducting the exam the eye care provider should complete the Eye Exam Report for IEP and either mail or fax the report to the child’s school. The form should be sent to the principal’s attention. The form will then be included in the child’s IEP folder as a reference for school administrators and parents. A copy of the eye exam form should also be faxed to 614-781-6521. Outcome data from the forms will be reviewed by a work group from the Optometric Association and Ophthalmological Society to determine the future needs and directions of the program.