Eye Clinic Eligibility Screening Form
- Must be an adult 18 years old or older.
- Must be a resident of Montgomery County.
- Household income must be below 175% of the Federal Poverty Guidelines.
- Must not have medical insurance that covers vision care.
- Must be referred by an authorized Montgomery County government or private nonprofit agency.
Referrals are accepted from caseworkers, social workers, and the following agencies:
Community Based Shelter
REAP (Assistant Program)