Children's Low Vision Project of BC
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DOWNLOAD FORMS

Online Referral Form

Please complete the online referral form. This is the first step in the referral process before a student can be approved for a clinic spot. You will be required to attach the student's most recent eye medical reports (must be within last 2 years) in a Word or PDF document. Please prepare these reports before beginning to fill out the form.

Download the CLVP - Online Referral Form

Student Forms

​CLVP team will contact you once your student has been accepted into one of our clinics.
Once your student's spot has been confirmed, you will be required to fill out the Student forms below.
These forms can be completed online, saved and submitted, or can be downloaded, printed, and submitted by fax or email. 
Please DO NOT mail these forms.


Please ensure your CLVP clinic placement has been confirmed before you download and fill out the forms.
The online referral form must be submitted first to determine eligibility. This can be done at any time.   

All forms are due back to the CLVP team three weeks prior to the clinic date (clvpbc@sd23.bc.ca)
Failure to return forms fully completed by the due date requested, may result in your clinic spot being given to another student
on the waitlist
.

Each child requires the following completed Clinic Forms:
  1. Educator form
  2. Parent form
  3. Consent form
  4. Orientation and Mobility form
  5. Medical form
  6. Video/Photo Release


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