KidSight's Follow-up Survey

Did you take your child to the eye doctor? Need more information about the screening or vision referral? Don’t have insurance and need help paying for an eye exam or glasses? Please complete the survey below.

Your Child's Name*

Your Child's School/Daycare

Your Name

First

Email*

Did you schedule an appointment with an eye doctor after your child's KidSight vision screening?*

Yes, we have seen an eye doctor

Yes, we have an appointment scheduled

No, but we plan to schedule an appointment

No, we do not plan to schedule an appointment at this time

Our child is already under care

Do you have any feedback for us?