Eye See…Eye Learn® Form

ESEL Monthly Reporting

Complete your monthly report by following the steps below.

Step 1 - Complete the Practice Information Below.

Practice Name*

OE Tracking Number

Step 2 - Select a Month and Enter Total ESEL Eye Exams

Select the reporting month from the dropdown calendar.
If you are submitting one report for the full ESEL year, select June and include all exams completed from July 1 to June 30.

Then enter the total number of ESEL eye exams completed during the reporting period.
Do not include exams where prescription glasses were required. If no exams were completed, enter 0.
Enter the last day of the reporting month as the reporting date.

Add a full year of past months

Reporting Month*

Monthly Eye Exams - no glasses*

Important

This report should be completed for each practice. The total should include eye exams completed by all ESEL optometrists at that practice. If a patient requires prescription glasses, the full patient exam form must be completed.

Tips for tracking ESEL eye exams

You can monitor your monthly exam totals using:

2025–2026 Count Sheet
2025–2026 Data Collection Sheet
EMR reports
OHIP monthly reports

Fields marked * are required.