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How to use or fill out Fill out application below and schedule appointment with referral agency
- Click ‘Get Form’ to open it in the editor.
- Begin by filling out Section 1, Applicant Information. Ensure all fields are completed, including your name, contact information, and social security number.
- Proceed to Section 2, Income Worksheet. Accurately list all sources of income for each household member. This includes employment, child support, and any other relevant income.
- In Section 3, answer whether you have received a doctor referral through the VISION USA program in the past two years. This is crucial for eligibility.
- Finally, review Section 4 for the signature requirement. Confirm that all information is true before signing and dating the application.
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