top of page
Form on Clipboard

IN-PERSON APPLICATION FOR VISION OR HEARING ASSISTANCE

DO I QUALIFY?

HOUSEHOLD INCOME MUST BE 200% OF POVERTY LEVEL

CURRENT PHOTO ID

NO OTHER INSURANCE THAT MAY PROVIDE YOU GLASSES OR HEARING ASSISTANCE

THAT SOUNDS LIKE ME. WHAT SHOULD I KNOW ABOUT THE APPLICATION PROCESS?

Step 1

FILL OUT AN APPLICATION PAY $5

Visit us at the center anytime between 9-2 Monday through Friday to fill out an application, no appointment needed! We will require a current ID, proof of income for your household and a $5 application fee.

Note: We only help individuals with glasses and exams once every 2 years.

Step 2

HAVE A SHORT INTERVIEW


The application will ask questions about your income, expenses and bills to make sure you qualify and get a better understanding of how new glasses or hearing aids will impact your day to day. Your application then goes to a committee on the THIRD TUESDAY of each month. On the same day our will make the final decision on whether or not to award funds.

Step 3

CHECK YOUR MAIL THE LAST WEEK OF THE MONTH FOR CONFIRMATION

Whether you are approved or denied, you will hear back from us in the form of a letter. If you are approved, the acceptance letter serves as a voucher to take to a participating provider from our list!

APPLICATION 
TO PRINT

Take a closer look

LIST OF PARTICIPATING PROVIDERS

VISION AND HEARING APPLICATION

bottom of page