Eye Consultancy / Eye Glasses Requirement

APPLICATION FOR ASSISTANCE IN PURCHASE OF SPECTACLES

Please fill in the form in case you have unclear vision, trouble seeing the blackboard, wearing eyes, frequent headaches.

Procedure:

  1. Please fill in the form below and select the doctor as well as the spectacles technician you want. Submit the form. After reviewing the application a token will be generated for you which will be mailed to you. If you do not have an email it will be whats-app-ed to you.
  2. Please carry the print out of this token and your original Aadhar card ( for verification) after setting up an appointment with the doctor. You will NOT be required to pay anything to the doctor.
  3. Share your prescription with us after consulting with the doctor.
  4. We will co-ordinate with the chosen technician to verify he has a suitable spectacles for you. We will then mail you a 2nd token which you print and take to the technician with your aadhar card as earlier. You will NOT have to pay for the spectacles.
Application form - Eye Care
Full Name
Note: If you don’t have email, please download the form and print it. Fill it in and whatsapp it to +91 87086 26933
REFERRED BY PRINCIPAL
12 digit Adhaar Number
The SSDJ foundation/doctors and all related teams are only providing the financial aid for the testing of the eye and payment for the recommended spectacles. It is not promoting any doctor or technician. Furthermore, the foundation/all related teams cannot be held responsible for the quality of consultation or of the products provided. The student opting for this specific aid understands that they themselves have chosen the doctor and the technician for the eye testing and purchase of spectacles and cannot and will not hold the foundation responsible for any mishap that may occur.