ViSION

Registration Form

Please fill out the form below to register for the Hopkins Vision Screening Event on X. This event is open to high school students in Baltimore. We have limited capacity at this screening, and we will accept patients in the order that the registration is received. You will be contacted to confirm your appointment.

Student Name(Required)

First Last

High School

Phone Number of Legal Guardian(Required)

Email of Legal Guardian(Required)

Address(Required)

Street Address Address Line 2 City State ZIP Code