LaunchEd Community - Hearing and Vision Screening May 3, 2024 
Dear Parent/Guardian of Student,

Thank you for taking the time to complete this intake. The screening will take place IN-PERSON.  Please submit by April 12th 2024.  We will follow up the week of April 15th.

If you wish to OPT OUT, please do NOT reply to this Google Form.

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Hola,

Gracias por tomarse el tiempo para completar esta ingesta. Envíela antes del 12 de abril de 2024.

Si desea OPT OUT, NO responda a este formulario de Google.
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Email *
I want to OPT IN for an in-person hearing and vision screening for my student.       Quiero optar por un examen de audicion y vision para mi estudiante. *
Student Name (FIRST and LAST)/Birthday.    Nombre del estudiante/Fecha de nacimiento y edad: *
Parent Name/Phone number.     Nombre del padre/Numero del telefono *
A copy of your responses will be emailed to the address you provided.
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