HOW TO RECEIVE SERVICE FROM MID-SOUTH LIONS
SIGHT AND HEARING SERVICE
You (the Lions Club) will need to complete an application for service when sponsoring a patient to the Mid-South Lions Sight and Hearing Service. There are separate applications for sight and
hearing, please use the appropriate application. The federal financial guidelines for determining indigent status must be strictly followed. Unless there are extenuating circumstances (there are very
few exceptions such as medical bills or recent unemployment) patients whose income is greater than the guidelines cannot be considered for service.
PLEASE NOTE, AS PER BOARD ACTION, ALL SIGHT APPLICATIONS MUST BE ACCOMPANIED BY A REFERRAL LETTER FROM AN EYECARE
PROFESSIONAL. INCOMPLETE APPLICATIONS OR APPLICATIONS SUBMITTED WITHOUT REFERRALS WILL BE SENT BACK TO THE LIONS CLUB AND WILL DELAY SERVICE TO YOUR PATIENT.
At this time, ALL hearing applications must be accompanied by a $250 check to cover the cost of on hearing aid. ($500 if the patient requires two hearing aids as prescribed by our audiologists) Most
clubs limit hearing aids to one per patient, per year, however if two are prescribed it is up to the club to determine if two will be purchased. If a hearing aid is not prescribed, the club has the
option of a refund, or allowing Mid-South Lions to keep the funds as a club contribution.
The main adult sight clinic is located on the 2nd floor of the Hamilton Eye Institute at 930 Madison Avenue in Memphis. Pediatric ophthalmology is located on the 4th floor of the HEI. The surgery
center is on the 3rd floor of HEI, or surgery can be performed at the Methodist University Hospital at 1256 Union Ave in Memphis. Additional satellite and specialty clinics (prosthetics, retinas) are
located throughout the four-state area (check the application for other locations).
Hearing clinics at this time located on the Ground floor of the Tower at Methodist University Hospital, 1256 Union Avenue in Memphis; the University of Memphis Speech and Hearing Center located at
4075 Park Ave Suite 201 in east Memphis; Bella Vista Hearing Center located at 22 Sugar Creek Center, Bella Vista, AR.
The hospital and clinics require proof of current income, such as a copy of the patient's current income tax return or a copy of the patient's last paycheck or social security check. It is also
important for you to make a copy of the application for your Club's records.
The interviewing Lion should meet with the patient and complete the form totally, then mail it to the Mid-South office. We will notify the patient and the interviewing Lion as to whether or not the
patient has been approved for service, and if approved when and where their first appointment will be. It will be up to the patient and the interviewing Lion to arrange transportation. At this time
there is a somewhat lengthy waiting period to get an appointment and/or surgery. Please be sure to include all the information requested on the form. It is important that you fill our the form
completely. Incomplete forms will cause unnecessary delays in processing the application. Please mail the application and applicable attachments to the Mid-South office, not the clinic. Faxing
applications will not expedite the process. The patient's first visit to Mid-South is for evaluation purposes ONLY. Please do not expect surgery on the first visit. Also, after hours emergency
service is not available through Mid-South Lions.
If you have a patient who needs urgent care, please call the office directly at 888-LION-042. If we determine that it is indeed an emergency case and the patient qualifies for service, we will do
everything we can to get the patient seen at one of our clinics as soon as possible.
Mid-South Lions Sight and Hearing Service depends on Lions Club contributions to continue providing "A Miracle A Day" to patients in your service area. Currently, Mid-South Lions suggested level of
giving is at least $25 per member, however a club contribution is not required to receive service and all contributions are welcome. Mid-South Lions Sight and Hearing Service appreciates your
assistance and your continued financial support.
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