Aws Visual Acuity Form PDF Details

In the realm of professional certification, the importance of meeting specific health criteria cannot be overstated, and this is where the AWS Visual Acuity Form plays a crucial role for individuals pursuing certifications in the welding sector. Located at 8669 NW 36 St, #130 Miami, FL 33166-6672 and reachable at (800)443-9353 extension 273 or via email at certification@aws.org, this form is an indispensable requirement for all SCWI/CWI/CAWI/CRI/CWEng applicants. Without a completed Visual Acuity Record on file, the American Welding Society (AWS) will not release exam results, recertification results, or renewals, emphasizing its critical nature. This form must be submitted prior to the exam, or at the latest, within 60 days after the certification exam for CAWI/CWI/SCWI candidates, and within 30 days for other programs necessitating a Visual Acuity Form. Failure to comply with these stipulations can result in voided test scores and applications, and possibly the forfeiture of application fees. The form mandates an eye examination to be conducted by licensed professionals ranging from Ophthalmologists to Certified Physician’s Assistants, ensuring that the applicant meets the near vision acuity on Jaeger J2 at 12 inches or greater, with or without corrective lenses, and passes a color perception test. This detailed protocol underlines the AWS's commitment to maintaining high standards within the welding certification process, ensuring that all certified individuals possess the necessary visual acuity to perform their tasks competently.

QuestionAnswer
Form NameAws Visual Acuity Form
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesjaeger eye exam form, visual acuity form, cwi eye exam, visual acuity test form

Form Preview Example

8669 NW 36 St, #130 Miami, FL 33166-6672

(800)443-9353 extension 273 Email certification@aws.org

VISUAL ACUITY FORM

MEMBER #: _______________ EMAIL ADDRESS: ______________________________________ DATE: _________________

LAST NAME: __________________________________ FIRST NAME: ______________________________ MI: ___________

Applicant

This form must be submitted for all SCWI/CWI/CAWI/CRI/CWEng applications ONLY.

AWS will not release exam results, recertification results, or renewals without a completed Visual Acuity Record on file.

IMPORTANT: This completed Visual Acuity Form must be sent to the AWS Certification Department prior to the exam, or no later than 60 days after the certification exam date for your CAWI/CWI/SCWI/ or 30 days for the rest of the programs requiring a Visual Acuity Form. Applicants who have not fulfilled all requirements after the certification exam date shall have test scores and application voided, and may be in jeopardy of forfeiting application fees. This form may be sent via fax, email, or mail.

Eye Examination

Eye examinations shall be administered by an Ophthalmologist, Optometrist, Medical Doctor, Registered Nurse or Certified Physician’s Assistant or by other ophthalmic medical personnel, and must include the state or province license number. Examinations shall be performed within one (1) year of the certification examination date, or within one (1) year of the certification expiration date for renewal or recertification of CWI/SCWI and seven (7)

months for all other programs requiring a Visual Acuity Form.

All applicants must pass an eye examination, with or without corrective lenses, to prove near vision acuity on Jaeger J2 at 12 in. or greater (≥30.5 cm). All applicants shall take a color perception test. Eye examination results must be documented on this Visual Acuity Record form supplied by the AWS Certification Department. No other forms will be accepted.

1.The following must be completed by the eye examiner:

A. Verify the customer’s close vision acuity to Jaeger J2 specifications at a distance of 12 inches or greater(≥30.5 cm)

(Check ONLY one of the following for each eye)

OD

OS

Requires corrected vision to read Jaegar J2 at 12 in. or greater.

No correction is required to read Jaegar J2 at 12 in. or greater.

Unable to read Jaegar J2 at 12 in. or greater even with attempt at correction.

B. Through a color perception examination, is the applicant colorblind?

(Check ONLY one of the following for each eye)

OD

OS

Customer IS NOT colorblind

Customer IS colorblind.

3. Examiner’s Contact Information (print clearly)

AWS Use

Only

W

O

NQ

AWS Use

Only

C

B

Customer Name:

 

Date of eye exam:

 

 

 

 

 

 

 

Examiner Name:

 

Phone Number:

 

Examiner Address:

 

 

 

 

 

 

 

 

 

 

 

City:State:

4. Examiner professional status (check only one)

Ophthalmologist

Optometrist

Zip/Postal Code:

 

 

Country:

 

Medical Doctor

Registered Nurse

Certified Physician’s Assistant

Examiner Signature:

State/Prov. License number:

 

 

 

 

Visual Acuity Form_1224

 

April 18, 2018

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