Request Eyeglasses

To obtain recycled eyeglasses from the Lions Eyeglass Recycling Center of Northern Virginia, complete an Eyeglass Request Form.  Complete the form in its entirety, then mail, e-mail, or Fax it to the Center at the numbers and addresses shown on the form.  If you need assistance completing the form, the Center staff is available to assist you.

 

Download or print the Eyeglass Request Form which is Adobe Acrobat or (pdf) format. The Center requests allowing it 8-10 weeks to fill your request.  Our ability to fill the request depends the lead-time that the applicant gives the Center gather the eyeglasses.

 

There is no charge for eyeglasses  However, the requestor must assure the Center that the glasses will be given free to needy people.  They must provide shipping instructions, pay for shipping and arrange for customs clearance.

 

After the mission, the requestor must report to the Center the number of people examined and the number of people fitted with eyeglasses on the Mission After Action Report form.  Please report any especially poignant or special events related to vision services on the mission.

 

We provide eyeglasses, 50 to a box, each box containing eyeglasses in the prescription ranges shown on the Eyeglass Request Form. 

 

The Center encourages all missions to staff themselves with medical or other personnel capable of determining a patient’s eyeglass prescription.  Priority goes to such missions, and to missions that give the Center the time specified on the Eyeglass Request Form to accumulate the requested eyeglasses. 

 

To contact us:

 

Lions Eyeglass Recycling Center

   of Northern Virginia

601 S. Carlin Springs Rd.

Arlington, VA 22204

 

 

Phone: 703-671-1919

Fax: 703-656-4787

E-mail: lercnova@verizon.net