Forms and Information for Clinical Directors
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With the help of the World Council of Optometry and other organizations, Special Olympics has been able to establish Opening Eyes initiatives in Africa, the Middle East, Latin America (such as this event in Paraguay) and the Asia Pacific region. |
For instructions on how to conduct a screening, download the “Special Olympics — Lions Clubs International Opening Eyes Guidelines for a Standardized Vision Screening” manual (67 pages, created 1999, revised 2002, 2006, Adobe PDF, 2M). This manual was authored by:
Sandra S. Block O.D., M. Ed.
Opening Eyes Director of Research and Education
Professor, Illinois College of Optometry
+1 (312) 949-7276
+1 (312) 949-7369 (Fax)
sblock@ico.edu
Clinical Directors participating in Special Olympics — Lions Clubs International Opening Eyes who wish to receive information on the Opening Eyes official protocols should contact Dr. Block.
The following forms are designed for the use of Clinical Directors when administering their individual programs:
- Hold Harmless Agreement (Adobe PDF, 124K): All health care providers volunteering to conduct health screenings at Special Olympics Healthy Athletes events must have malpractice insurance that covers the Healthy Athletes related activites. This form's mutual hold harmless language is a method by which each party is protected.
- HAS Opening Eyes Screening form (Microsoft Word, 290K, updated 4 April 2006) More information on HAS — Healthy Athletes Software system
- Manual for Healthy Athletes Software (HAS) Data Input (Adobe PDF, 565K)
- United States-based Program Needs form (rev. February 2004, Adobe PDF, 83K)
- Non-U.S.-based Program Needs form (rev. February 2004, Adobe PDF, 102K)
- 2006 Event Data Summary form (Adobe PDF, 79K or Microsoft Word document, 39K)
- “Congratulations...glasses” form (Adobe PDF, 153K)
- “Screening Report Card” form (Adobe PDF, 159K)
- Essilor Lenses Replacement Order form (Adobe PDF, 32K)
- Special Olympics — Lions Clubs International Opening Eyes Grant Application form (Adobe PDF, 10K)
The following forms, designed for the use of Clinical Directors when administering their individual programs, are in Spanish. Los formularios siguientes, diseñó para el uso de los Directores Clínicos al administrar sus programas individuales, están en Español:
For general questions about the Healthy Athletes/Special Olympics — Lions Clubs International Opening Eyes programs, contact David Evangelista, Manager, Healthy Athletes, +1 (202) 628-3630 or devangelista@specialolympics.org
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