Applications for Services
Here you will find all the applications needed to sign up for our free services. All documents are saved as PDFs. If you have any questions, please call us toll-free at 1-800-BRAILLE (272-4553).
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Eligibility Application Form
- This form is for adults who are interested in signing up for our free classes. Please contact the Regional Center Location nearest you to arrange an appointment with an admissions counselor. You must have a referral from an ophthalmologist, optometrist or health-care provider.
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Low Vision Services Physician Referral Form
- To schedule a free consultation with one of our Low Vision Consultants, you must have a referral from an ophthalmologist, optometrist or healthcare provider, but you need not be legally blind. Consultations are available at Braille Institute's five regional centers. Once you have your medical referral, simply call the Regional Center nearest you and schedule an appointment for your consultation.
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Library Services Application Form
- Applications for our free Library Services must be documented by a competent authority such as a physician, nurse, optometrist, therapist, hospital or nursing-home professional, social worker or librarian. Family members are not eligible to certify as a competent authority. If you have trouble downloading this form, please call the Library's toll-free line at 1-800-808-2555 and we'll be happy to send it to you by standard mail.