2024 Operation Sight Grant Application

2024 Operation Sight Grant Application

All applicants must complete the application below:
Was your organization an Operation Sight Grantee in 2023?*

YesNo
Total Grant Amount Awarded in 2023*
Total Number of Charitable Cataract Surgeries Provided in 2023 to Patients who meet or exceed the Operation Sight Patient Criteria*
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Grant Main Point of Contact Information

Main Point of Contact for Grant Communication
Contact Title*
I.e. Executive Director
Contact Name*

First NameLast NameTitle (If applicable)
Contact Email*
example@example.com
Contact Phone Number*

Area CodePhone Number
Street Address*
City*
State*
Zip Code*
Location for charitable cataract surgeries (if different from address provided above):

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Grant Requirements
Operation Sight Grant funding is intended to support charitable cataract programs in the United States serving the Operation Sight patient population. Patients should not be charged for any portion of their cataract surgery or care unless it is outside of the 90-day global cataract period.

To qualify, patients must be vetted to meet the following criteria:
- Must be at or below the 200% of the Federal Poverty Level defined by the Federal Poverty Guidelines. Documentation of household income and dependents must be provided.
- Must be uninsured or underinsured where insurance does not cover any portion of cataract surgery. Patients who receive Medicare Part B are ineligible. The program does not pay or assist with copays or deductibles.
- Must have a formal cataract diagnosis where cataract surgery has been deemed medically necessary.
- Must permanently reside in the United States. Applicants who are temporarily visiting do not qualify for the program.
By submitting this application, I attest our programs meet the eligibility requirements of the grant. Please sign using your mouse below.*

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Organization Information
Which option best describes your charitable cataract program?*

Our charitable cataract program is a verified 501(c)(3) organizationWe have an affiliation with a verified 501(c)(3) organization, where we will source patients and provide patients with charitable care at our facilities
Organization Name*
Organization Mission*

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Organization Website
Name of Affiliated 501(c)(3) Organization*
Affiliated 501(c)(3) Organization Mission *
Affiliated 501(c)(3) Organization Website*
Upload Organization's 501(c)(3) status verification*

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Funding Request
Requested Grant Amount for 2024*
Anticipated Cost Per Surgery for 2024*
Program Budget for Humanitarian Cataract Care within the U.S.*
Please list major financial contributors to your humanitarian cataract care program.*
Please list in-kind contributors to your humanitarian cataract surgery program. Please include industry replenishment contributions. *
Charitable Cataract Program Details
Charitable Cataract Program Description*

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How will the Operation Sight grant funding support your local efforts to make cataract care more accessible to underserved patient populations? *

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Does your organization currently track your charitable surgical and program impact? Please note: Approved applicants are required to track all surgeries and provide bi-annual reporting, which includes providing charitable surgical data by date and volunteer. Program testimonial content from either patients, volunteers, or community members is also requested. *

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How many charitable cataract surgeries do you anticipate providing during the calendar year 2024?*
How many of these anticipated surgeries will be supported through the grant funding requested?*
If the number of cataract surgeries in 2023 is less than 2022, please describe any challenges you encountered.*

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Does your program provide charitable eyecare beyond cataract surgery within the US? If yes, please describe. *

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Patient Care
Please describe how you source patients locally and what your eligibility criteria and screening processes are. Please list any documentation that patients are required to provide during this process. *

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Do your patient eligibility criteria mirror Operation Sight’s? If not, please explain in detail how you will ensure funding is used for this population only, as well as how you will ensure patients are not charged for their charitable cataract surgery and associated care through the 90-day global cataract period.*

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Awarded grantees may be referred pre-screened eligible patients by Operation Sight for charitable cataract surgery. Does your organization have a process in place to ensure these patient referrals receive care in a timely manner? Please explain in detail.*

Please note that Operation Sight patients are pre-screened and should not complete additional internal vetting services. 0/400
Additional Details
Please utilize this space for any additional details you would like to share.

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Should be Empty:

2024 Operation Sight Grant Application

Grant Main Point of Contact Information

Grant Requirements

Organization Information

Funding Request

Charitable Cataract Program Details

Patient Care

Additional Details