Vision and Hearing Screening Opt-Out form
Dear parents and guardians,
As stated on the Illinois Department of Public Health website, adequate vision and hearing are paramount to educational performance. Impaired vision and/or hearing in children can seriously impede learning and contribute to the development of educational, emotional and behavioral problems. Early discovery and treatment can prevent or at least alleviate many of these problems. The IDPH mandates that vision and hearing screening be done for children in Pre-K, Kindergarten through 3rd grade, 8th grade, transfer students, and all special education students. At Burnham school, we will be providing vision and hearing screening for those students previously mentioned. This will take place during the school day on December 9th and 10th. We highly recommend that each of these students be screened. If you do NOT want your child to be screened at school, this form must be filled out and turned in to the office prior to the screening date. Please note that vision screening does not take the place of a comprehensive eye exam. If your child is in kindergarten this year, or was in kindergarten last year and did not receive an eye exam due to COVID, your child needs to have an eye exam in addition to vision screening.
I have read and understood the information above. I do not wish to have my child participate in hearing and vision screenings at this time.
Click here for the Vision and Hearing Screening Opt-Out form.
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Student name Parent/guardian printed name
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Parent/guardian signature Date