Center Application

The Iris Network Rehabilitation Center

Please complete both the Client Admissions Application and the VRC Authorization Form, and return them along with the requested attachments. 
* You may need to click Enable Editing after opening the documents in Word.

Click here to download the Client Admissions Application

Click here to download the VRC Authorization Form

By email (preferred): admissions@theiris.org

By U.S. Mail:

The Iris Network Rehabilitation Center
Attn: Joyce Earle
189 Park Avenue
Portland, ME 04102

We request the following attachments: 

  1. Your most recent eye report, which should be no older than 6 months. To get a copy of your eye report, contact your eye doctor.
  2. A medical report from your primary care physician; you may download our Request for Medical Information form here. The report should include a physical, cognitive and emotional assessment. The report should indicate whether your physician feels you will require limitations or restrictions to activity while at The Rehabilitation Center.
  3. Copies of your most recent vision rehabilitation reports.
  4. A copy of your health insurance card (front and back).
  5. A copy of your guardianship decree, if applicable. 

If you have any questions, please do not hesitate to contact us at the numbers below. 

Maine candidates: Joyce Earle, 1-207-774-6273 ext. 3315; admissions@theiris.org 

National candidates: Amber Mooney, 1-207-774-6273 ext. 3329; amooney@theiris.org

Support Us