Please provide an email address we can use to contact you about this application.

Please select the option that best describes what you are applying for. The form will show different questions and supporting document requirements depending on your selection.

Please note that magnification equipment and technology or electronic equipment applications require an assessment from a specialist Blind Low Vision NZ staff member. For these application types, a specialist staff member will complete the assessment and application with you or on your behalf.

This section must be completed by a specialist Blind Low Vision NZ staff member for magnification or technology applications. Please provide details of the client’s needs, the recommended solution, any products trialled, and why this support is required.

Please include your eye exam report so we can confirm your visual acuity, a quote for the frames and/or lenses so we can see what you are seeking funding for, and your lens prescription so we can confirm the lens strength and assess whether the lens cost is fair and reasonable.

Frames can only be funded up to $200 including GST, while lenses may be funded where the cost is fair, reasonable, and needed to meet optical requirements.

Use this section if you are applying for funding towards the fitting fee for hearing aids.

Please include your audiologist report and a quote that clearly shows the cost of the fitting fee. 

Funding is capped at 25% of the fitting fee, up to a maximum of $375, and any approved funding will be paid directly to the supplier.

The Pearson Fund will not normally consider applications if you have received hearing aid fitting support within the last three years, unless there has been a change in your diagnosis that requires new hearing aids to be fitted.