Report an InfantSEE Assessment

Infantsee Assessment with your optometrist

InfantSEE providers are strongly encouraged to submit a Clinical Reporting Form for each InfantSEE assessment that is performed. Reported data not only provides information on how many  babies' lives are impacted by the program, but also provides  crucial reporting that helps fuel our mission. When you submit a report you ensure that eye and vision care continue to be readily accessible to infants across the country. 

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Print Clinical Reporting form and complete it during InfantSEE assessment.


InfantSEE provider or staff visit and input Clinical Report Form.


You support AOA advocacy efforts for children's vision intitiatives through reported assessments

InfantSEE also provides the Clinical Reporting Form (Long) and Patient History Form for your convenience. Please do not return these forms to InfantSEE -- these are for office use only.
Infant History Form Download || Clinical Reporting Long Form Download

Fill out my online form.

Why Submitting Clinical Reporting Forms Matters:

Magnifies InfantSEE Eye Exams Magnifies the importance of early eye and vision care
Magnifies InfantSEE Eye Exams Supports AOA advocacy efforts for children's vision initiatives
Provides InfantSEE Metrics Provides metrics needed to secure monetary support


Clinical Reporting Forms can be submitted in one of three ways:

  • Electronically
  • Fax: 314.991.4101
  • By Mail: Attn: InfantSEE, 243 N. Lindbergh Blvd., St. Louis, MO 63143

InfantSEE Partners