Downloads & Resources

Pre-Examination Forms

Pre-examination forms help Calgary Vision Therapy prepare for your scheduled evaluation. Please download and complete the forms that match your appointment type before your visit.

"It is a matter of 'what you are, compared to what you could be.'"

Pre-examination forms for Calgary Vision Therapy evaluation

Before Your Appointment

Please complete the forms that match the type of evaluation you scheduled. These forms help Calgary Vision Therapy understand your concerns before your visit.

For example, your forms may include details about symptoms, visual comfort, reading, learning, eye teaming, focusing, or previous eye care. If your visit relates to reading or learning concerns, our Vision & Learning page explains how visual skills may affect school and daily tasks.

Before your appointment, review each page and make sure the information is clear. Also, bring any glasses, contact lenses, previous reports, or referral notes that may help the doctor understand your case.

If the appointment is for a child, a parent or guardian should complete the forms as fully as possible. Details about reading habits, attention, headaches, eye strain, school work, and computer use can help our team understand the concern more clearly.

For adult evaluations, please include symptoms that affect work, reading, driving, sports, screen use, or daily activities. In addition, note when the symptoms started and whether they changed after an injury, illness, or new visual demand.

If you are unsure which form to complete, please contact our office before your appointment. For a general overview of eye exams, review the American Optometric Association eye exam resource.

Learning Difficulty - Visual Information Processing Evaluation

2021 Child Visual Information Processing Forms (Pdf)
2021 Child Strab BV Visual Information Processing Forms (Pdf)
2021 Adult Visual Information Processing Evaluation Forms (Pdf)

Strabismus, Amblyopia, Lazy Eye Pre-Examination Forms

2021 Child Strabismus Amblyopia Forms (Pdf)
2021 Adult Strabismus Amblyopia Forms (Pdf)

Binocular Coordination, Accommodative Dysfunction Pre-Examination Forms

2021 Child Binocular Vision Evaluation Forms (Pdf)
2021 Adult Binocular Evaluation Forms (Pdf)
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