Coachella Valley Visually Impaired Community Services

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
73411 Dalea Lane
Palm Desert, CA 92260

Download the Client Registration Form