Lions Eyeglass Recycling Center of Northern Virginia 

Request Eyeglasses for a Mission 

To obtain recycled eyeglasses from the Lions Eyeglass Recycling Center of Northern Virginia, complete an Eyeglass Request Form (The Eyeglass Request Form in Microsoft Word (.doc) format)

The Eyeglass Request Form in Adobe Acrobat (pdf) format

Complete the form in its entirety, then mail, e-mail, or FAX the completed Eyeglass Request Form to the Center at the numbers and addresses shown on the form.  If you need assistance completing the form or estimating the types of eyeglasses to request, the Center staff is are available to assist you.

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

There is no charge for eyeglasses.  However, the requestor is responsible for:

The Center encourages all missions to staff themselves with medical or other personnel capable of examining a patients eyes and determining a patient’s eyeglass prescription.  Priority goes to missions that: