Appointment for Mandated Vision & Hearing Screening
The following grades are part of the Mandated Vision & Hearing Screening taking place at the Richard's Center by PSHS & DLA.

- Kindergarten
- 2nd grade
- 5th grade
- 8th grade
- 10th grade

Book your appointment below.
Sign in to Google to save your progress. Learn more
Email *
Student name / Nombre de Estudiante *
Student grade / Año Escolar *
Student ID # (1315...) / Identificación de el Estudiante (1315...) *
Date of Birth / Fecha de Nacimiento *
MM
/
DD
/
YYYY
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of Palm Springs U.S.D.. Report Abuse