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Referring Patients with Vision Loss

State Services for the Blind serves Minnesotans who have a vision loss that is significant enough to interfere with daily life. Once you refer a patient to us, one of our counselors will contact them to let them know more about how we can assist them and set up an appointment to meet with them.

A Note about Minn. Stat. Chap. 248.011

Minnesota law governs the responsibilities of ophthalmologists and optometrists to inform patients who are legally blind about the services of SSB. We also encourage eye care professionals to talk about our services to patients with progressive vision loss, even though they may not yet have a diagnosis of legal blindness.

How to Refer a Patient

For your records, you will need the patient’s signature on a document indicating that you have their permission to make a referral to SSB. You may wish to download and copy this form in order to have them on-hand. If you would like us to send you a packet of these consent forms, please check the appropriate box below and provide your mailing address. The secure form below asks for patient’s name, contact info (phone or email), and ZIP Code. We will match them with one of our counselors based on their ZIP Code.

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