Patients can self-refer into the service

If you have visited a GP, Optometrist or Pharmacy regarding a minor eye condition and been given a self-referral card, please fill in the form via the button below.

Once you submit this form, a member of our team will contact you very shortly to book an appointment. Please ensure that the telephone number you leave on the form is the correct one we can contact you on.

Patient Self-Referral Card:

Appointment Card

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