Do I Qualify? Lighthouse Vision Services Prequalification Questionnaire Lighthouse Vision Services Prequalification Questionnaire If you are human, leave this field blank. 1. Have you lived in Georgia for a minimum of 12 consecutive months (leading up to today)? * Yes No 2. Do you have a current, government-issued photo ID? * Yes No 3. Do you currently have vision insurance? * Yes No 4. We serve individuals with household income up to 200% of the federal poverty guidelines. Can you provide current proof of income for ALL members of your household? * Yes No Submit
