The Eye Clinic addresses the need for vision testing, glaucoma screening, and prescription eyeglass service for patients without vision insurance. Opened in 1999, all services provided in the Eye Clinic are free for our guests. Referrals must be submitted by caseworkers and faxed to the Eye Clinic’s attention along with proof of income and proof of residency in the D.C. metropolitan area.
In addition to the Eye Clinic Eligibility Screening Form, patients must also sign Eye Clinic Appointment Questionnaire.
Eligibility to Receive Free Eye Care:
- Must be an adult 18 years old or older
- Household income must be below 175% of the Federal Poverty Guidelines
- Must not have medical insurance that covers vision care
- Must be referred by any authorized government agency or non-profit organization in the D.C Metropolitan areas
For questions about eligibility and referrals, please contact Angely De La Rosa at [email protected] or dial (301)-585-6463 X203
Eye Clinic Eligibility Screening Form
Eye Clinic Appointment Questionnaire
Referrals are accepted from caseworkers, social workers, and the following agencies:
Avery Road Treatment Center
Bethesda CaresCASA of Maryland
Catholic Charities
City of Gaithersburg
Community Based Shelter
DELAI
Department of Health and Human Services
Every Mind
Interfaith Works
Montgomery County Coalition of the Homeless Montgomery County Crisis Center
MUM (Mid County)
Pathways
REAP (Assistant Program)
Sophia House
TESS Community Service Center UMAN (Upper County)
WUMCO (Western Upper)
On The Day of Your Appointment:
- Arrive 20 minutes before your scheduled appointment
- Bring photo ID
- Check in with the Eye Clinic assistant
- Complete the forms
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