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Registration-ADVT HE Webinar September 25, 2025

Please complete the registration information below and click the "Done " button. For further information, contact Lauras@pbohio.org. You will receive a Zoom link in your e-mail a week prior to the training

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* 1. Preferred Salutation

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* 2. First Name

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* 3. Last Name

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* 4. Home Address

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* 5. Work phone number

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* 6. Home or Cell Phone number

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* 7. Preferred E-mail address

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* 8. Alternate e-mail

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* 9. Job title, volunteer position, or student. If you are a student or volunteer put where you go to school or where you volunteer (or plan on volunteering.) Include the address and organization below.

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* 10. Work Address

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* 11. Once you complete training, are you willing to be contacted to provide vision screenings in your area?

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* 12. Have you been certified as an adult vision screener by Prevent Blindness  in the past?

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* 13. If yes, are you taking this class to re-certify?

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* 14. If yes, do you have the near and distance charts as well as Registration/Risk Assessment Forms?

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* 15. This next group of questions is the pre-test.
Please complete and click "done" at the end.
What is the center portion of the retina where the sharpest vision can be achieved?

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* 16. What is the clear, transparent outer layer of the eye that protects the front of the eye?

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* 17. Which of the following are the most common eye diseases in aging adults?

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* 18. Age-related macular degeneration is a disease that affects

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* 19. Which of the following is NOT a factor that increase the risk of diabetic retinopathy?

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* 20. You can lower your risk of eye disease and vision loss if you:

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* 21. Controlling your blood pressure is a good idea for protecting your eyesight.

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* 22. Questions or comments

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