Low Vision Collaboration Clinic+ Forms

Low Vision Collaboration Clinic+ is for infants, toddlers, or school-aged children who have alternative communication and complex needs. At these clinics the primary goal is for educational teams to learn how the student sees and what accommodations and supports could be implemented to aid in access to the curriculum.

Please complete the following KanLovKids LVCC+ Forms.

• TSVI/COMS complete the following form:
  • TSVI/COMS Clinic Request Form

• Parents complete the following forms:
  • Read the KanLovKids Information Letter
  • LVCC+ Participation and Consent Form
  • Child/Family History Form
  • Eye Gaze Permission Form

If you require paper forms, please email kanlovkids@kssdb.org.

ALL DOCUMENTS ARE DUE PRIOR to a student being scheduled for a clinic.

If an interpreter (ASL, spanish, etc.) is needed, please email opens in a new windowkanlovkids@kssdb.org.

On the day of the appointment, please bring supported seating equipment, trays for travel or wheelchair, along with toys and objects the child prefers.