However you were referred to us, please, be prepared to provide some personal information
You may provide your request for consideration by any of the following options:
- Your name, your local phone, your local address, (and, if you have or are an advocate, his/her contact information),
- Help requests submitted by an advocate/HELPER requires contact information so we can contact the HELPER.
- Describe the history of what you have done to resolve this need before coming to us,
- What, if any, insurance do you have, what is your income, your relative need,
- Can you provide a state or county Access Coverage Entitlement (ACE) or equivalent documentation of need (generally required for major expense help)?
- What is your recent employment history?
- Identify any prescribing doctor who you will allow to provide us insight into your needs
- Advise care provider you wish to release information to Lions Sight and Hearing representatives.
- If you have an existing estimate, be prepared to deliver hard or electronic copy of your estimate.
- Communication limited (speech or hearing) clients may wish to contact us through Tri-County GLAD.
- Conservative requests are most likely to succeed.
- Download the below Excel sheet (BEST) and provide it to one of our 38 clubs
- Our prior electronic submission form has not worked, you must find a club to assist you and your needs.
- DO NOT EXECUTE / SUBMIT the below Subpage '7 - App Form ...', it will go nowhere! Fetch, fill and email or mail the form to a Lions Club near your home.