Florida Lions Foundation for the Blind

Florida Lions Foundation for the BlindFlorida Lions Foundation for the BlindFlorida Lions Foundation for the Blind

Florida Lions Foundation for the Blind

Florida Lions Foundation for the BlindFlorida Lions Foundation for the BlindFlorida Lions Foundation for the Blind
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    • Home
    • Life Memberships
    • Applications & Forms
    • Campership & Fundraiser
      • Campership Application
      • Fundraiser 2020
    • Legal Information
    • Resource Links

  • Home
  • Life Memberships
  • Applications & Forms
  • Campership & Fundraiser
    • Campership Application
    • Fundraiser 2020
  • Legal Information
  • Resource Links

So, take your time, look around, and learn all there is to know about us.

MAIL APPLICATIONS FOR APPROVAL with ALL completed PAPERWORK including the $200 Copay check to your DISTRICT PROJECT CHAIRS. The PROJECT CHAIRS are as follows: 

 

     MD 35 PROJECT CHAIR

PDG Norma Callahan

P.O. Box 1113

Deland, FL 32721

386.453.4877

 

District L - East:

PDG Norma Callahan

P.O. Box 1113

Deland, FL 32721

386.453.4877


District L - West:

PDG Nell Simmons

10145 Noriega Drive

Pensacola, FL 32514

850.501.6601

 

District I - North:

PDG Louis Cantrell

1032 15th Avenue

St. Petersburg, FL 33704

727.647.2663


District I – South:

PDG Blair 'Chip' Kunka

8634 54th Avenue West

Bradenton, FL 34210

941.713.7069

 

District O - East:

Lion Aleta Dick

3110 Oceanshore Blvd #211

Ormond Beach, FL 32176

724-875-9236

r.n.aleta@hotmail.com


PDG Audrey Hall

11179 SW 71st Terr. Rd.

Ocala, FL 34476

352.854.6715

pdgaudrey@ocalalionsclub.org 


District O – West:

Lion Dan Fox

2 Smilax Court North

Homosassa, FL 34446

352.382.2127

716.572.4693

 

District N - North:

Lion Crystal Samuel

4041 Greenwood Drive

Fort Pierce, FL 34982

772.940.9939


District N - South:

PDG Norma Callahan

P.O. Box 1113

Deland, FL 32721

386.479.9896

 

Florida Lions Eye Clinic

Lion Shaira Ramirez

10322 Pennsylvania Avenue

Bonita Springs, FL 34135

239.498.3937

 

Florida Lions Foundation For The Blind

Executive Secretary/Treasurer

Life Memberships and Donations

Lion Anita McHenry

256 Fifth Street Northwest

Largo, FL 33770

727.688.4350


THE PROJECT CHAIRS WILL REVIEW THE APPLICATIONS AND SCHEDULE EYE EXAMINATIONS TO DETERMINE THE CORRECT DIAGNOSIS BEFORE SENDING THE CASE TO PDG NORMA CALLAHAN FOR SURGICAL APPROVAL. 

PAPERWORK includes the following:

*PAPERWORK includes the following:

  • Project Form, which can be found on Foundation’s website: floridalionsfoundation.org
  • Financial assessment
  • If the person is under 65: DBS or Division of rehab denial.
  • If the person has insurance denial of coverage.
  • $200 check


 

Directions for Completing and Submitting
Application Requesting Assistance for Surgery

Attention: When completing and submitting the Application Requesting Assistance for Surgery, the Projects Form must also be completed at the same time.

  1. No after-the-fact cases will be accepted.
  2. The sponsoring club pays for examination(s), if possible.
  3. The Foundation only pays amounts approved on surgical cases.
  4. The Medical Agencies bills MD-35 Projects Chairperson. This information is provided to them on the Authorization Form when the case is approved.
  5. When you receive a request for financial assistance for surgery, complete in full both the Projects Form and the Financial Eligibility Application form with necessary signatures using the Poverty Level Schedule as a guideline. Both forms must be completed!
  6. All clients must apply for assistance from the Division of Blind Services (DBS) and Vocational Rehab before coming to the Foundation. If they are denied assistance from DBS or Voc Rehab, have them get a letter stating reason for denial and submit it with the application. The Foundation does not get involved with clients who have Medicare, Medicaid, or any other form of insurance.
  7. Your club's co-payment must accompany the required forms when submitting a request for assistance. Please make the check payable to: The Florida Lions Foundation for the Blind, Inc. The requested amount is $200.00 per surgical case for either one or two eyes.
  8. Please attach a copy of the patient's social security card or a copy of their Green Card if applicable to the forms.
  9. EMERGENCY CASES:
    A. Clubs with emergency cases must immediately notify District Projects Chairperson.
    B. One-eye cataract cases are not emergency cases.
    C. Esotropia, exotropia, and lazy eye are emergencies only for ages 5 and under.
  10. If a case is not completed within 6 months following approval, it will be cancelled.


Note: Your assistance in making sure all information needed is provided on the forms will greatly expedite the process. Please remember that it is not the responsibility of the Projects Chairperson to acquire the client's information. It is our responsibility to try to negotiate costs with medical agencies once we receive the precise procedure to be done with the code numbers and the estimated costs.
The Foundation is here to assist all Lions Clubs in

Florida and The Bahamas.


See Attachments:

Eligibility Application Form (pdf)

Download

Projects Form (pdf)

Download

App Filing Procedure for Eye Surgery (pdf)

Download

Patient Form 11-9-21 (pdf)

Download

Patient Form Spanish 11-9-21 (pdf)

Download

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