Diagnostic Products
Diagnostic Products
Diagnostic Products
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Vision<br />
KEYSTONE VIEW RECORD FORMS<br />
554010184853 Vinyl Matrix for OVS Form #8 SPECIAL ORDER: Minimum Order<br />
10 Packs, 3 pd/pk<br />
727-22610184863 VS II / VS IV Universal Target Record Form, 3 pd/pk<br />
735-14510184828 OVS Rapid Screening Record Form, 3 pd/pk<br />
735-23610184852 Orthoscope Refractions Form OTR (5˝ x 8˝), 3 pd/pk<br />
735-23710184833 Professional Performance Test Form (8 1/2” x 11˝), 3 pd/pk<br />
735-26910184844 OVS Test Record Form #8, 3 pd/pk<br />
735-27010184835 OVS Test Record Form #9, 3 pd/pk<br />
735-27210184825 Doctor’s Record Form #3A Visual Skills Profile (8 1/2” x 11˝), 3 pd/pk<br />
735-272-110184826 Doctor’s Record Form #3A Visual Skills Profile (5˝ x 8˝), 3 pd/pk<br />
735-27310184827 Driver Test Set Record Form #10, 3 pd/pk<br />
735-27510184848 Visual Survey Short Test Form #4, 3 pd/pk<br />
735-27710184823 Delacato Test Summary Sheets, 3 pd/pk<br />
735-27810184824 Leavell Test Sheets, 3 pd/pk<br />
735-28710184845 Visual Tracing Test Form Groffman, 3 pd/pk<br />
735-38410184837 Industrial Short Test Form #12, 3 pd/pk<br />
735-38510184834 Professional Performance Test Form (5˝ x 8˝), 3 pd/pk<br />
735-38610184850 Doctor’s Form #2A VS (8 1/2” x 11˝), 3 pd/pk<br />
735-386-110184851 Doctor’s Form #2A VS (5˝ x 8˝), 3 pd/pk<br />
735-38810184830 Skills Test Form DG-P, 3 pd/pk<br />
735-38910184831 Skills Test Form DG-1 / DG-2, 3 pd/pk<br />
735-39010184832 Skills Test Form DG-3 / DG-4, 3 pd/pk<br />
735-39410184829 Spache Binocular Reading Test Record Form, 3 pd/pk<br />
735-39710184836 Vinyl Matrix Overlay for OVS Form #9 SPECIAL ORDER: Minimum<br />
Order 10 Packs, 3 pd/pk<br />
735-39910184839 Ready to Read Record Form #6, 3 pd/pk<br />
735-40010184822 Multi-Stereo Scoring Form, 3 pd/pk<br />
735-40110184849 Mark Diplopia <strong>Diagnostic</strong> Chart, 3 pd/pk<br />
735-40210184847 Visual Survey Parents Notify Form, 3 pd/pk<br />
735-40310184838 OVS Referral Form #66, 3 pd/pk<br />
736-16110184821 Stereometric Record Form M-DC, 3 pd/pk<br />
736-38610184841 School Survey Form #5B (2 Part Form) Use w/005-135, Follow by<br />
005-100, 3 pd/pk<br />
736-56110184840 School Survey Form #5A, 3 pd/pk<br />
736-69810184842 Visual Skills Survey Form, Use w/005-135 / 005-100, 3 pd/pk<br />
736-69910184843 Peek-A-Boo Series Form (8 1/2” x 11˝), 3 pd/pk<br />
736-74410184857 Employee Vision Record Form #9-A, 3 pd/pk<br />
736-77610184854 Modified Telebinocular Technique Form, 3 pd/pk<br />
736-80410184856 Peek-A-Book Series Form (5˝ x 8˝), 3 pd/pk<br />
736-83210184855 Palmer-Freed Dissociation Form, 3 pd/pk<br />
736-87810184859 Pilot Vision Test Pre-Record Form, 3 pd/pk<br />
737-01710184860 Physician’s Visual Rating Form, 3 pd/pk<br />
737-02510184861 DVS II / DVS III / DVS IV Record Forms, 3 pd/pk<br />
737-025A10184865 DVS-GT Standard Record Forms, 3 pd/pk<br />
737-16110184858 Walton MVS Form W-T, 3 pd/pk<br />
737-225-110184866 VS II / VS IV Standard Record Form (Replaces 737-225A, 737-131,<br />
737-225 & 737-254) English, 3 pd/pk<br />
737-225B10184862 VS II / VS IV Standard Target Record Form (2 Part Form) Spanish,<br />
3 pd/pk<br />
737-25510184864 VS II / VS IV Universal Target Record Form (5˝ x 8˝), 3 pd/pk<br />
738-76910184846 Aniseikonia Record Form R1, 3 pd/pk<br />
KEYSTONE VIEW SERVICES AND SETS<br />
006-10010184810 Visual Skills Program 1 (Screen) Includes Instruction Manual, 728-056,<br />
005-100, 735-272 & 735-272-1<br />
006-10110184811 Visual Skills Program 1 (Diagnose) Includes Instruction Manual,<br />
Rating Cards, 728-056, 005-100 & 735-237<br />
006-10310184812 Brock Technique Service, Includes 28 Large Plastic Slides & Lightbox<br />
006-10710184815 Combined Programs 1 & 2 Screening & <strong>Diagnostic</strong> Test Set<br />
006-11610184816 Hand-Eye Coordination Test Set, 3 test/set<br />
006-12910184817 Keystone 3-D Fusion Games Set, Includes: 20 Red, Green & Black<br />
8 1/2” x 11˝ Picture Charts, Easy-to-Use Manual, Easel, Pointers, Record<br />
Forms & 1 Pair Red/Green Filters<br />
006-13010184818 Basic Binocular Test Set, Includes: 12 Special Targets Bound in Flip Chart<br />
Form, Non-Glare Plastic-Coated Cards, Red/Green Filters & 1 Pair of<br />
Pointers<br />
006-16910184819 Economy Color Book Package, Includes: 10 Books, 10 Red Crayons &<br />
1 Pair Red/Clear Filters<br />
610410184813 Complete Van Orden Program, Kit Includes: Keystone View Correct Eye<br />
Scope, The Van Orden Trainer, 16 Transparency & Opaque Slides, 1 Set<br />
of Split Cards, Red/Green Filters, 2 Pads of Van Orden “Star” Graphs<br />
w/VO-1 matrix, 2 Pads of Training Charts & Manual<br />
610610184814 School Vision Screening Program: Includes 728-030 w/005-100 &<br />
005-135, Instruction Manual, Familiarization Chart & 736-386<br />
619310184820 Pediatric Vision Screening Service, Comes Equipped with the Visual<br />
Survey/School Telebinocular & Peek-A-Boo Test Set, Instruction Manual &<br />
100 Peek-A-Boo Test Forms<br />
WELCH ALLYN SURESIGHT VISION SCREENER<br />
Screen with one-button touch from 14˝ away. Five-second, automatic test<br />
addresses compliance problems and makes testing easier. Minimal cooperation is<br />
required, making it ideal for use with young children. The lights and sounds<br />
engage the child’s attention. Automatically measures and indicates abnormal<br />
readings. Addresses eye charts’ sensitivity and specificity problems. Automatically<br />
screens for common vision problems, including near- and farsightedness,<br />
astigmatism, and anisometrophia. Hand-held unit operates for three hours of<br />
continuous testing. Available battery-operated printer enables you to get printouts<br />
anywhere, anytime. Weighs two lbs. and features an ergonomic grip and<br />
replaceable, self-adjusting hand strap. Features optics and electronics shockmounted<br />
inside housing to protect unit. The sealed unit helps keep out dirt.<br />
Screens babies, children, and adults. You can even test patients while they’re<br />
wearing glasses or contact lenses.<br />
1400010112568 SureSight<br />
Accessories<br />
05140-U10112570 Carrying<br />
1404210112569 Thermal<br />
5360010112571 Printer<br />
Vision Screener Set, Includes 110-130V Charging Transformer<br />
& Stand<br />
Case<br />
Printer<br />
Paper, 24/cs<br />
91<strong>Diagnostic</strong> <strong>Products</strong>