Skip to main content
Home » Nursing Home Care » Authorization Forms

Authorization Forms

We recommend that all long term care residents be screened upon admission to discover any performance deficits that may be linked to eye disease or malfunction. Our Screening Authorization may be downloaded below:

Visual Screening Authorization Form (PDF)

If a resident is known to have an eye disease or functional problem and screening is not necessary, you may use the direct authorization form link below:

Nursing Home Patient Authorization Form (PDF)