Navigator Program Application
The purpose of the Friedman Place Navigator Program is to provide a broad range of case management and social services to people who are blind in order for them achieve the greatest level of self-determination, independence, and interaction within the community. Navigator staff informs, educates, supports and empowers clients who are blind or visually impaired along with their families and friends in many areas, including (but not limited to) obtaining and maintaining Public Entitlement Programs, Social, vocational, educational, and housing services, and Healthcare. To be eligible, the individual must be 18 years or older, legally or totally blind, an Illinois resident, and living in the community (as opposed to a residential or similar program). Staff are available to meet in offices in Chicago’s loop and the northwest side and – as resources allow – to accompany clients to locations such as social security, the Secretary of State’s office, banks, etc. Many services can be provided remotely by phone, email, and regular mail. Staff do not provide transportation or provide orientation and mobility training. There is no charge for the services.

Please fill out this application completely. Thank you!
Email address *
Name:
Your answer
Today's Date
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Address (number and street):
Your answer
Address (City and State):
Your answer
Address (Zip Code):
Your answer
Date of Birth
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YYYY
Home phone:
Your answer
Cell phone:
Your answer
Email:
Your answer
Are you legally blind?
Are you a resident of Illinois?
Are you living in a private apartment or house (as opposed to a housing, long-term care, or other residential program?
What is your gender (for statistical purposes only)
What is your approximate annual income? Note, some programs that we work with have income requirements.
How many people live in your home?
Are you currently working with any organization that specializes in serving people who are blind (select all that apply)
If you chose "Other Organization", please explain
Your answer
What type of services do you think that you might possibly need assistance with (choose all that apply)?
If you chose "Other", please explain
Your answer
Is there any additional information that you think would be helpful?
Your answer
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