Full Membership – Optometrist Response Form

Greetings Colleague!

has applied for membership at Vision Therapy Canada.

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- I am comfortable vouching for this potential member
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- I can attest that the applicant named above offers complete-scope in-office Vision Therapy.
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- I can attest that the applicant named above provides computer and/or home-based Vision Therapy only as adjunct therapy and not as stand-alone treatment.
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- I acknowledge that fraudulent applicants AND vouching full members will have their membership revoked.
Please tell us why you are not comfortable vouching for this potential member. Your comments will be forwarded to our membership committee.
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Applicant Email Address
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