Report Request Form

If school accommodations are needed please be as specific as possible regarding what you would like included in your report: (Example: Testing in a room free of distractions, etc...)

Please provide your method of payment below. Payment is due when your report is requested. Fax request to (405) 755-1875 or email to info@afeyecare.com. Please allow 2-3 weeks for report.

Thank you