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THE LIONS VISION CLINIC AT MEND NEED WITHDIMEET MALIGNITY www.mendpoverty.orgMENDDISTRICT 4L1MEND 10641 N SAN FERNANDO RD TACOMA, CA 91331 REFERRAL Format: Referral From (Name of Lions Club): Name
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Start by collecting all the necessary information, such as your personal details, medical history, and any specific vision concerns.
02
Read the instructions provided on the form carefully before you begin filling it out.
03
Begin by filling in your full name, date of birth, contact information, and address.
04
Move on to providing details about any existing medical conditions or allergies that are relevant to your vision health.
05
If you have any previous eye surgeries or treatments, make sure to mention them accurately.
06
Fill in the specific vision concerns or symptoms you are experiencing, including details such as when they started and their intensity.
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If you are currently taking any medications, provide the names and dosages in the appropriate section.
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Answer any additional questions asked on the form regarding your lifestyle, occupation, or specific requirements.
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Review the completed form to ensure all the information is entered correctly and legibly.
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Finally, submit the form to Lions Vision Clinic either by mailing it to the provided address or dropping it off personally.

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Anyone who requires vision-related medical attention, consultation, or assistance can fill out the form for Lions Vision Clinic.
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This may include individuals experiencing vision problems, those in need of eye examinations, individuals seeking treatment or surgery, or anyone interested in general eye health and care.
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Form Lions Vision Clinic is a document used by Lions Clubs to report activities and financial information related to vision screening and eye care services provided to the community.
Lions Clubs and associated organizations that provide vision services must file Form Lions Vision Clinic to account for their activities and finances.
To fill out Form Lions Vision Clinic, gather all relevant information regarding your club's vision-related activities and expenditures, then complete each section of the form accurately before submission.
The purpose of Form Lions Vision Clinic is to ensure transparency and accountability in the activities and operations related to vision care services offered by Lions Clubs.
The information that must be reported includes details about vision screening events, participant counts, funding sources, expenditures, and any partnerships or collaborations.
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