Eye Examination and Eyeglass Program Support and Application

Eligibility Requirements	Applicant must be a resident of Morgan County, Georgia. Applicant must demonstrate financial need. Applicant must be unable to pay for services or obtain assistance from other available sources. Applicant must submit a complete and signed application with requested supporting documentation. Application may not be submitted within 24 months of a prior application.
Available Assistance	Eye examinations. Low-cost eyeglasses. Referrals for other vision-related services.
Program Limitations	The program does not cover eyeglasses or services obtained before approval. The Madison Lions Club will not reimburse purchases or bills incurred before approval. Submission of an application does not guarantee approval. All assistance is subject to available funds, volunteer support, and provider participation.
Application and Review	Applicants must complete the Vision Services Application fully and truthfully. The Club may request documentation to verify residency, income, insurance, or other eligibility information. For applicants under age 18, a parent or legal guardian must sign the application and required authorizations. A Lions Club member will review each application and may contact the applicant for additional information. If application has been submitted in the last 24 months, those applications will be reviewed at the end of the year and considered only if there are remaining funds available.
Confidentiality and Contact	Applicant information will be handled confidentially in accordance with the signed application and HIPAA authorization. The Madison Lions Club may communicate with another person only if the applicant has signed a release permitting that contact. Mail application to Madison Lions Club, P.O. Box 183, Madison, Georgia 30650 Or Email to: lions.club.madison@gmail.com

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