Official State of Rhode Island website

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State of Rhode Island Office of Rehabilitation Services Department of Human Services

Referral Form - Eye Report

Please fill out and fax this referral form back to Services for the Blind and Visually Impaired (SBVI) at (401) 222-1328. (To be filled out and returned by examiner.)

Referral Form

Eye Report with text fields.pdf PDF file, less than 1