Screening Forms


SEE HAPPINESS

To take your free screening, you will need AdobeReader® to download the forms.


ADULT'S FREE SCREENING FORM 

Could you benefit from vision therapy?  Fill out this free screening and see how vision may be affecting reading, work, driving, and life.  Bring the form with you to your exam to save yourself time in our office. Dr. Cook will need the information to tailor your care.

Download & Print Form


CHILDREN'S FREE SCREENING FORM

Could your child benefit from vision therapy?  Fill out this screening form to discover how vision may be affecting your child's reading, learning, and life.  Bring the form with you to your child's examination to save yourself time in the office.  Dr. Cook will need the information to tailor your child's care.

Download & Print Form

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