Prevent Blindness Texas partners with key resource partners to support individuals along the full continuum of eye care. These strategic partnerships allow us to provide eligible individuals with financial assistance for free comprehensive eye exams and/or eyeglasses through the referral component of our program. By working together with our resource partners, we ensure that those we serve are connected to the appropriate eye care services they need.
To apply for the CHILDREN’S component of our referral program, please download and submit the completed application form:
Sight for Students Program Application Form-English
Sight for Students Program Application Form-Spanish
PLEASE NOTE: This program is available for children aged 18 and under, or up to 19 years old if currently enrolled in high school.
To apply for the EYEGLASSES ONLY component of our referral program (for both children and adults), please download and submit the completed application form along with a copy of your current eye prescription, which must be dated within the past year:
Healthy Eyes Eyeglass Program Client Application Form-English
Healthy Eyes Eyeglass Program Client Application Form-Spanish
Incomplete applications will not be processed.
Allow 4-6 weeks for your application to be reviewed and processed.
For questions about your application, please contact Prevent Blindness Texas at [email protected].
Note: The forms are available in Adobe Acrobat PDF format. If you don’t already have it, you can download the Acrobat Reader for free. If you are having trouble using Acrobat Reader, visit Adobe’s Acrobat Support page.