Preschool Screening Inquiry

Please complete the short form below to inquire about scheduling preschool vision screenings at your site.

Your Name:*
Your Email:*
Enter Email Confirm Email
Phone*
The Name of Your Childcare Center:*
The County Where your Childcare Center Operates:*
The Number (Approximate) of Children Enrolled Between the Ages of Two and Five:*
Does your center serve Head Start, NC Pre-K, or Title 1 Pre-K children?*
- Yes
- No
- I'm not certain
Your Message*