Get Kentucky Vision Project

The Kentucky Vision Project application is a vital document designed to assist individuals in obtaining necessary eye care services. This guide provides clear, step-by-step instructions for completing the application online to ensure a smooth submission process.

Follow the steps to successfully complete the Kentucky Vision Project application.

1. Press the ‘Get Form’ button to access the application form and open it in your editor.
2. Enter today’s date in the designated field, ensuring the format is clear and correct.
3. Provide your Social Security number in the specified field.
4. Indicate your county of residence in the next section.
5. Fill in your full name, including first, middle, and last names.
6. Complete the mailing address section with your street address.
7. Provide your city, state, and zip code in the appropriate fields.
8. Enter your phone number, ensuring to follow the format provided.
9. Input your email address in the designated area.
10. Record your date of birth in the specified field.
11. If applicable, list up to two counties you will travel to if there is no participating doctor in your county.
12. Indicate the date of your last eye examination and provide the name of the examining doctor.
13. Fill out the family member information section, including names, relationships, ages, and whether they are covered by Medicare or Medicaid.
14. If applicable, answer questions regarding children in the household without a Social Security number or vision insurance.
15. Complete the family income information by providing total gross income for each member, along with proof of income.
16. Indicate any additional resources you have, including checking or savings accounts.
17. List any existing health insurance sources for your family.
18. Indicate whether anyone in your family has been accepted into the Kentucky Vision Project before and provide their names if applicable.
19. Review all information entered to ensure accuracy before submission.
20. Once completed, save your changes, and choose to download, print, or share the form as necessary.

Complete your Kentucky Vision Project application online today to access essential eye care services.