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Order practice giving materials

 
Your participation in the Practice Giving Program is an admirable undertaking for your practice and for you as an individual. Your practice becomes part of the global team to eliminate preventable blindness by the year 2020 by making the decision to support Optometry Giving Sight through the Practice Giving Program. Your support will help us give sight and hope to millions in need.
 
Before we get started, please let us know where your office is located:
 
 
 

Please indicate the materials you would like sent to your practice

QUICKSTART KIT
(I would like to get started with Practice Giving in my practice.
Please send me the Quickstart Kit that includes all of the materials)
 
Item #1 - PATIENT INFORMATION SHEETS
(Notepads of 100 sheets - 1 sheet needed for each patient)
 
Item #2 - COUNTER CARD
(To place on your reception desk)
 
Item #3 - PRACTICE WALL CERTIFICATE
(To place in your reception area)
 
Item #4 - BOOKMARK
(Gesture of thanks for each donation)
 
Item #5 - GIVING SIGHT LEAFLET
(1 Needed for each patient)
 
Item #6 - QUICKSTART KIT INSTRUCTIONS
(Training information for the staff)
 
Item #7 - RETURN ADDRESS LABELS
 
Item #8 - OPTOMETRY GIVING SIGHT DOCTOR VIDEO
(Doctor and staff mini-video for use with staff or in professional presentations - 5 minutes)
 
Item #9 - OPTOMETRY GIVING SIGHT DVD
(Patient mini-video for the reception area - 2 minutes)
 
 
Title:
First Name:
Last Name :
Email:
Address:
City:
State/Province:
Zip/Postal Code :
Phone:
Fax:
Comments/Questions:
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