DENVER EXECUTIVE BOARD
AGGIE EXECUTIVE BOARD
DALLAS EXECUTIVE BOARD
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
with any questions.
SPECIAL THANKS TO OUR PRESENTING SPONSORS
FOR PROUDLY SUPPORTING
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...
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...
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.
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59 Cavalier Blvd. Suite 310 Florence, KY 41042