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Your Zip Code will help us determine your congressional district for advocacy efforts.

Please Note:

Prevent Blindness may reach out to you about telling your story to members of a state assembly, becoming a volunteer patient spokesperson for the initiative or other opportunities to share your story to the public.

The information you have provided in this form will NOT be shared with any private entity including corporations or businesses, employers, or insurance companies. By volunteering to share your story, you will help us educate policy makers about the potential impact of Step Therapy on the eye health patient. Thank you for sharing! 

Please contact Sara Brown, Director of Government Affairs, with any questions:
[email protected]