You are viewing the unstyled version of the Center for Macular Degneration's website. To view the styled version, try turning on Cascading Style Sheet (CSS) support in your browser (if it is off) or upgrading to a newer browser with CSS support.

Home > Low Vision Rehabiltation > Needs Assessment

Low Vision Needs Assessment

To determine your need for vision rehabilitation services, please answer the following questions.

Becuase of your vision, do you have trouble reading regular size printed materials?
Because of your vision, do you have trouble signing your name on a document?
Because of your vision, do you have trouble making a phone call without operator assistance?
Because of your vision, do you have trouble telling time with a watch or clock?
Because of your vision, do you have trouble managing your personal affairs?
Do you have trouble recognizing people?
Do you have trouble watching TV?
Because of your vision, do you have trouble with activities of daily living (e.g. cooking, sewing, shopping, personal grooming)?
If you drive, do problems with your sight cause you to be fearful when driving?
Because of your vision, do you have trouble with independent travel at home or in the community?
On a scale of one to 10, how do you feel about your life right now (1=worst, 10=best)?

If you answered "yes" to any of the questions above, or if problems with your vision are decreasing your satisfaction with life, you may benefit from vision rehabilitation services.

Top of Page | Home