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Low Vision Materials Order Form PUBLICATIONS PRICE QUANTITY TOTAL COST LEAP Fact Sheet (IAD 419) (packet of 25 sheets) US $1.50 packet $ Low Vision Information & How To Use (IAD 440) (packet of 25

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1. Start by gathering all the necessary documents and information such as medical records, optometrist reports, and any other relevant documents.
2. Fill out the personal information section accurately, providing details such as name, age, address, and contact information.
3. Provide a detailed description of your vision impairment and any specific needs or requirements you may have.
4. Include information about any assistive devices or technologies you currently use or may need in the future.
5. Specify the level of assistance you require and whether you would like to be contacted for further information or updates.
6. Sign and date the form to ensure its validity.

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1. Individuals who experience significant vision loss or impairments may require low vision services.
2. Those with conditions such as macular degeneration, diabetic retinopathy, or glaucoma may benefit from low vision - lions.
3. People who struggle with daily activities such as reading, writing, cooking, or navigating their surroundings due to visual limitations can benefit from low vision - lions.
4. Individuals of all age groups, including children, adults, and seniors, may require low vision services.
5. Low vision - lions can support individuals who have exhausted all other treatment options and still face limited vision.
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What is low vision - lions?

Low vision-lions is a form used to report individuals who have low vision and may require additional assistance or accommodations.

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Health care providers or individuals responsible for the care of individuals with low vision are required to file low vision-lions.

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Low vision-lions can be filled out by providing detailed information about the individual's visual impairment, any assistance or accommodations needed, and the contact information of the responsible party.

What is the purpose of low vision - lions?

The purpose of low vision-lions is to ensure that individuals with low vision receive the necessary assistance and accommodations to improve their quality of life.

What information must be reported on low vision - lions?

Information that must be reported on low vision-lions includes the individual's medical history, visual impairment diagnosis, recommended accommodations, and contact information.

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