NCLSA Van Reservation Form

NCLSA Van Reservation Form 22.0KB

Vision Screening Unit Reservations - Contact Lion Jim Kirkpatrick kirkpatrick32@comcast.net  916-725-0369

Mail forms to NCLSA Vision Screening/Plus Optics

4413 Arbroath Way, Antelope, CA 95843


This is a mobile unit that is owned by NCLSA and is used for Glaucoma and Visual Screening services. 

We provide a driver and our completely equipped van.  Lions Clubs may reserve this unit by completing the reservation form and paying a fee for usage.  Your club is responsible in obtaining a professional to perform the screening.

Usage Fees are $150 (VIP Members) $250 - $100 a day beyond first day (Non-VIP Members) is due with this form  to reserve the van, the cost is increased by $50 (VIP Members) per day over the first day.  The fee covers insurance, gas and maintenance.  VIP clubs may reserve the unit 12 months ahead.


Recommendations for A Successful Vision Screening:

Determine a date, time and place for your screening.  Give yourself enough time to plan properly.  Reserve the van as soon as possible.  Set aside approximately 6 to 8 hours for the event.  Location is everything.  Hold your event somewhere with a lot of traffic (shopping centers, health fairs, cultural festivals, etc.).  If necessary, make sure that you have received the appropriate permission to park the van at your location.  The van is approximately 37 feet long and 9 feet wide including the side mirrors.

Secure the services of at least two optometrists or ophthalmologists as soon as possible.  The more advance notice you give the better your chance of securing their services.  At present we a CT-80 Computerized Tonometer, a Titmus 2A Reader on board with a hand held Tonometer and Plus Optics.  Doctor must provide their own solution.

On the day of the event, make sure you have enough members to adequately staff the entire day.  There should be at least 3 to 4 Lions present at all times to help with registration, assisting the doctor, etc.

Vision Screening Unit Reservations


Contact:   Lion Jim Kirkpatrick

kirkpatrick32@comcast.net  

916-725-0369