To request a VSP Vision™ Eyes of Hope® mobile clinic to provide free vision care for disaster relief or for a population in need who qualifies, please fill out this form. Questions? Contact us at mobileclinic@vsp.com.
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All fields required unless otherwise noted.
Mailing Address
Practice/Organization Information
To request a VSP Eyes of Hope mobile clinic to provide free vision care for disaster relief or for a population in need who qualifies, please fill out this form. Questions? Contact us at mobileclinic@vsp.com.
*Charitable, community-based, or educational events not related to disaster relief or vision care outreach considered on a case-by-case basis as our schedule permits.
A brief description of your event: Who will be helped, event details and event purpose, any additional organizations participating.
Event Start Date and Time
Events with less than three months’ notice will be declined. Multi-day events of seven or more hours each day will be given priority.
Event End Date and Time
Note: The event location must be able to accomdate a mobile clinic up to the following specifications:
Length: 45’ Height: 13’6” Width: 12’ (parked); 8’6” (traveling) Weight: 38,000 lbs
All fields are required unless noted.
*Eligibility All services are offered on a first-come, first-served basis, for individuals who meet the following qualifications: