Lions of Michigan Foundation - KidSight Vision Screening - School/Daycare/Agency Request Form
Worldwide, the leading cause of reduced vision in children is an unidentified need for them to wear glasses.  Our KidSight Program is designed to quickly and accurately identify treatable causes of vision loss in young children in a noninvasive and low stress environment.  Participation is voluntary, and no fees are charged for a child’s vision screening.

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Email *
Event Name - Site - School - Daycare *
Contact Person *
Contact Person's Telephone Number (Daytime) *
Contact Person's Email Address *
Vision Screening - Requested Date *
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Vision Screening Location:  Street Address *
Vision Screening Location:  City, State, Zip Code *
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