Deerfield Valley Lions Eyeglass and Hearing Aid Assistance Program

The Deerfield Valley Lions provide financial support for our local communities for the purchase of prescription eyeglasses or hearing aids whenever possible. Applicants must fill out a basic form that is reviewed by the club’s Sight/Hearing chair and if deemed appropriate, assistance will be provided. All information provided to the club will be kept in the strictest confidence and used only for the purpose of providing the requested assistance.

The Lions do not provide assistance for exams, tests or special features on eyeglass or hearing aids. Any such exams, tests or features that are included in the purchase are the sole responsibility of the applicant. 

The Deerfield Valley Lions do not have specific Vision or Hearing Aid centers that they work with and the applicant is free to choose their own provider. 

Process Steps

1. Complete the Eyeglass and Hearing Aid Assistance Form. The PDF file can be filled out electronically or printed and filled out by hand.


2. Print and sign the form. All forms must be signed by the person requesting the assistance or their representative/guardian.


3. The form can be scanned and sent in by email to dvvtlions@gmail.com or mailed to: ​​

Deerfield Valley Lions
Sight and Hearing Chair
PO Box 367
Jacksonville VT 05342

4. Once received the Lions will review the request and follow-up with any further questions if necessary. The applicant will be informed of whether the request has been approved or not. If approved, the amount approved will be also be provided.


5. If approved, the applicant will be provided with a voucher that the provider can submit to the club for reimbursement. If the provider doesn't honor vouchers, the applicant has 90 days to submit a detailed receipt showing where and when the eyeglass or hearing aids were purchased and must show details of additional features that were purchased. If the returned voucher or receipt is for less than the approved amount, the amount of the receipt will be reimbursed, otherwise the approved amount will be reimbursed.