CCLVI SCHOLARSHIPS The Council of Citizens with Low Vision International Scholarship Applicant’s Eye Report Form To be completed by an Ophthalmologist or Optometrist Name of Applicant: _______________________________

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Date: 2010-12-28 00:39:00 LogMAR chart Visual acuity Visual impairment Blindness Low vision Hermann Snellen Disability E Chart Snellen chart Ophthalmology Vision Medicine		CCLVI SCHOLARSHIPS The Council of Citizens with Low Vision International Scholarship Applicant’s Eye Report Form To be completed by an Ophthalmologist or Optometrist Name of Applicant: _______________________________ Document is deleted from original location. Use the Download Button below to download from the Web Archive. Download Document from Web Archive File Size: 365,63 KB

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