Service Forms

Before receiving services from GDABVI, you'll need to complete forms that give us permission to discuss your needs, share information among staff who'll be working with you, give us background on your vision situation, and request information from your eye care professional.

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After you've completed and submitted your forms, you'll then be contacted for next steps. You can also call our office to speak with our Community Care Coordinator at 313-591-3790 to request that someone assist you in completing the forms by phone.

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STEP 1

Click here to complete our online consent form. This form gives consent for GDABVI to use and release the client's personal information as needed in order to provide  services. Consent forms are good for three years from the date signed unless we're notified in writing that the client or their authorized representative is revoking consent.

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STEP 2

Click here to complete our online intake form. This form collects information about the person we'll be assisting and what they need help with. We suggest allowing 5-15 minutes to complete this form.

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STEP 3

Click here to download a copy of our Vision Exam Form. This document needs to be completed by the client's vision care professional. 

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We look forward to working with you!