Does Your Club Provide Vision Assistance?

Each year, KidSight provides referrals that are vital to ensuring that MO children receive the eye care they need. Some of the children referred by KidSight require assistance as they are uninsured and cannot afford an exam. We’re asking Lions Clubs to participate in a survey that aims to gather insight about the vision assistance your Club provides. This information will help us streamline our follow-up process when aworking with a child in your community.

Lions' Club information

Lions' Club Name(Required)

Does your Lions Club provide vision assistance for children in your community?(Required)

Yes

Club Contact Information

Let us know who we should contact when reaching out to your Club about assistance opportunities.

Club Contact(Required)

First Last

Title or Position in Club

Preferred Method of Contact

Your Email Address(Required)

Email Address Confirm Email Address

Tell Us More About Your Assistance Program

Any Question for KidSight?

We would love to tell you more about our work! Let us know if you have any questions about KidSight.

Your Comments/Questions