Optometry & Eyewear
Low Vision Rehabilitation Intake form template
A compassionate intake for low-vision rehabilitation services. It captures functional goals, current aids, and the tasks that matter most so our specialists can recommend magnification, lighting, and adaptive strategies.
SchedulingRehabilitationAccessibility
What’s in the box
Goal-focused care
We build a plan around the daily tasks you care about most.
The right aids
From magnifiers to lighting, matched to your vision.
Perfect for
- Macular degeneration
- Low vision aids
- Daily living support
- Reading assistance
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