If you are in need of assistance to receive vision or eye services, please fill out and submit the application below. Once you complete and submit the application, Sight for All will review and determine eligibility for assistance.
Even if you are insured, you may qualify for assistance depending upon the deductible and type of service.
If you are an optometrist or ophthalmologist and require assistance for your patient, please fill out the application below and submit for review. Once we receive your request, the patient will need to fill out the financial application available above. Sight for All will notify the doctor and patient if they qualify for assistance.
MEDICAL ASSISTANCE FORM
P.O. Box 125, Youngstown, OH 44505 (330) 779- 8045 EMAIL: firstname.lastname@example.org