Vision/Hearing Screening

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Please fill out if you are opting your child out of the vision/hearing screening?

Vision/hearing screenings will begin for 10th graders and new students to the county once students are back in the building. The state of Virginia mandates that these screenings are to be done each school year and we have to have it in writing that the parent does not want the screening. These screenings help identify possible defects that could impede learning.

Last Name *

First Name *

Student Grade *

School year

Please select one *

- My student is a virtual learner and I DECLINE the screening

- My student is a Hybrid Learner and I DECLINE the screening

Parent Type full Legal Name as Signature *

To Be Filled out by FHS

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of Fauquier County Public Schools. Report Abuse

Forms