Client Registration Form

If you have been diagnosed with low vision or a form of vision impairment, then CVVICS can and will assist. Please download and fill out the form below. Once completed, you can email the form to info@cvvics.org. You can also print the form and send by mail to:

CVVICS
c/o Barbara Foyil
35074 Mission Hills Dr. Rancho Mirage, Ca. 92270

Download the Client Registration Form