Our Program The program was founded in 1992 by the Miami Dade Optometric Physicians Association. We currently operate as a division of the Miami Lighthouse for the Blind and Visually Impaired to provide free eye exams to eligible students throughout the state of Florida. Last year, we served more than 11,000 students through mobile unit visits and vouchers for in-office exams with participating optometrists.

Vision Screening

Who Can Apply? ALL PRE-K-12 public school students can apply for the program. We are not restricted to the state-mandated grades for vision testing. Even children who do not fail a vision screening in Miami-Dade County can apply for our program.

Benefits of Promoting the Mobile Application The coordinators will be reaching out to all of the schools to update their contact information and fax number and to make sure that they have all of the information. We will send digital copies to each school of the consent forms with our mobile application information that will also include the department code for the parent. One side is flyer for the mobile application instructions and in case they cannot access that, the consent in the same language will be printed on the back. If you need your customized consent form and you have not been contacted, please call our office at 305-856-9830. We are in the last stages of development of our mobile application and it will be available for the school year. The application can be accessed in the 3 main languages for our demographic area. It is easily accessed by smartphone, tablet or computer on our website: www.floridaheiken.org We highly encourage the school to give the information on our mobile application to the parents to speed up the process. The parent must obtain the school code for our program and the failed screening date from their flyer needed to apply using the mobile application. Once the parent completes the mobile application electronically, within a week, the school will receive, by fax, a copy of the consent form with the eligibility status. We will communicate with the schools by fax to either provide a voucher or an ineligible letter to copy and send home to the parent or we will call schools, with enough eligible students, to schedule a mobile visit. Consent forms take 3-4 weeks to process, the mobile application will take one week or less. Consent forms are frequently received with missing or illegible information, unsigned and require multiple phone calls and their staff resources as well as ours to resolve the information in order to process the application resulting in even further delays. The mobile application

Mobile Application and Parental Consent Forms The mobile application links and printable consent packets and fax cover sheets are available on our website at www.FloridaHeiken.org

Mobile Application View on Smartphone or Tablet

Mobile Application

Parental Consent Forms Please ensure that parents enter all of the required information clearly and legibly The box on the upper left hand corner must include the failed vision screening date for the students that have failed the screening Signatures: The first signature gives us the authorization to provide the eye exam The second signature authorizes us to use the child’s insurance benefits if applicable

Fax Cover Sheets To streamline our processing, please use the Florida Heiken fax cover sheets with your application submissions Please specify on the fax cover sheet if your school is requesting a mobile unit visit or voucher(s) for an in-office appointment Mobile unit visits require at least 15 eligible students. Exceptions can be made for two schools that are in close proximity to one another

Eligibility – Voucher Process We will fax the designated school contact a copy of the voucher to give to the student(s) to take home to the parent/guardian The voucher includes the contact information for the participating optometrist office so that the parent/guardian may schedule an appointment

Eligibility – Mobile Unit Process If your school has met the minimum requirement of 15 eligible students, a Heiken Coordinator will call the school contact to schedule a mobile unit visit Exam Day Procedure: The school nurse will be asked to bring 5 to 7 students at a time to the exam area/mobile unit A school monitor must be present at all times to supervise the waiting students. Heiken staff may only attend to the student being examined Students will receive a dilated exam and will be provided with post-dilation sunglasses

Eligibility – Mobile Unit Process Heiken staff cannot examine any students wearing contact lenses. Should the student choose to remove the lenses prior to the exam, it must be done prior to entering the mobile unit. Copies of prescription forms will be made at the school and given to the school contact for distribution to the students. If a student is absent on the day our Licensed Optician is scheduled to dispense glasses, the glasses will be returned to the Heiken office where they may be picked up by parents or arranged to be mailed.

Ineligible Students If a student is not eligible, we will fax an ineligible letter to the school contact to be sent home to the parent/guardian. We do not issue vouchers for students insured by these plans.

Future Developments Consent forms will soon be available online via desktop and mobile on the Florida Heiken website. We will notify school contacts as soon as the online forms are ready. Please encourage parents and guardians to apply online once it is available. It will be less work for school staff and faster processing times for eligibility!

Florida Heiken Children’s Vision Program Statewide Program Coordinator Questions? Contact Us: Florida Heiken Children’s Vision Program (305) 856-9830 Program Coordinator Christina Gallardo cgallardo@miamilighthouse.org Statewide Program Coordinator Stephanie Rojas srojas@miamilighthouse.org