Referral Process

Who should be referred to the clinic?

• Students who are 3.5 years old - Grade 12 who have low vision.  (Low vision is a term used to describe limited sight (20/70 acuity or less with the best possible correction) and/or a reduced field of vision.)

Who can refer to the TLVC?

• Pediatricians
• Ophthalmologists
• Optometrists
• Schools/Preschools
• Vision Consultants
• CNIB

Note: The referral form can be completed at ANYTIME to request a clinic spot for upcoming clinics. We keep a waiting list and consider these referrals when planning future clinics. Due to the number of referrals we receive and the limited clinic spots that we can provide each year, BOTH ONLINE FORMS AND THE PARENT CONSENT FORM must be completed, 3 weeks prior to the clinic. Failure to return forms FULLY completed by the due date requested could result in your clinic spot being given to another student on the wait list.  Successful attendees will be notified two weeks prior to the clinic date.

The Parent Consent Form can be attached to the parent questionaire or e-mailed directly to edc.liss@gov.ab.ca

Referral Forms:

• Referral Form
• Parent Questionnaire
• Parent Consent Form

Thank you!