VISION USA APPLICATION WORKSHEET IS AVAILABLE FOR DOWNLOAD
Download and print an application worksheet and deliver completed worksheet along with income verification documents to a charitable organization, social worker, case worker, community health agency for eligibility verification and application submission:
- VISION USA Application Worksheet – English
- VISION USA Application Worksheet for New Jersey Residents
All applications will be reviewed. If an applicant is approved, the agency will receive an email notification of doctor assignment on behalf of the client. It is the agency’s responsibility to provide the doctor information to their client. If you are not currently working with a case worker, see “Referral Agencies.”
Application worksheets are also available by sending a self-addressed stamped envelope to:
243 North Lindbergh Blvd.
St. Louis, MO 63141
Phone: 1-800-766-4466 (Automated System)
DO NOT MAIL OR FAX APPLICATIONS TO OUR OFFICES. ALL APPLICATIONS “MUST” BE SUBMITTED BY REFERRAL AGENCY. SEE “REFERRAL AGENCIES” SECTION TO FIND OR BECOME A REFERRAL AGENCY.