Patients
Evaluation Process

The evaluation phase consists of

1. an application for consideration;
2. a student and family interview;
3. a developmental vision consultation;
4. my analysis;
5. a narrative report; and
6. a patient and family conference.

The process is comprehensive and takes approximately six hours to complete. It is imperative that we serve you well. We enroll a limited number of patients each month and need to determine the most effective care for you. Therefore, we will consider this application by the completion of the following checklist and the receipt of an application fee check made out to Specialized Visual Solutions, OD, PLLC in the amount of $150. Please understand that this is applied to the subsequent evaluation process and will be refunded immediately if we deem that this "case" is not within our criteria for treatment.

Please indicate all symptoms or behaviors that may apply and make any necessary editorial comments. Mail your response and check to the above address at your earliest convenience. You should receive a follow-up phone call shortly thereafter.

Patient Self Assessment Form