Von Miller | Von's Vision Foundation | A Prolanthropy-Managed Organization

If your student is participating in Von's Vision Day, please print off the following documents, filling out a separate form for each student. For your student to participate, they must have these forms completed and signed by a parent, guardian or supervisory adult for the student's organization. Blank copies of the documents below will always be provided at check-in to be filled out and signed on site.

Patient History Form

Parental Consent Form (English)

Parental Consent Form (Spanish)

Please email Michael Lusk at michael.lusk@prolanthropy.net with any questions.

SPECIAL THANKS TO OUR PRESENTING SPONSORS

FOR PROUDLY SUPPORTING


IMPACT According to a 2012 study titled “The Social and Economic Impact of Poor Vision” conducted by The Boston Consulting Group and Essilor, 30% of children experience...		NEED According to recent data collected by Von’s Vision, 38% of children in the United States need some form of vision correction. Three out of every ten children under six years old...		WHY As a child, Von remembers times when we went to school without glasses or was made fun of because of his glasses. Without glasses, it was impossible to see, impossible to...

ENRICH THE LIVES OF INDIVIDUALS
AND FAMILIES IN NEED.

DONATE NOW

SPECIAL THANKS TO OUR PRESENTING SPONSORS

FOR PROUDLY SUPPORTING

IMPACT

NEED

WHY

ENRICH THE LIVES OF INDIVIDUALS AND FAMILIES IN NEED.

ENRICH THE LIVES OF INDIVIDUALS
AND FAMILIES IN NEED.