All fields marked with * are mandatory.

Appointment Type*

Please select an appointment type.

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Personal details

First Name*

Please enter your first name.

Last Name*

Please enter your last name.

Date of Birth*

Please enter your birth date.

Gender

Patient Id (if known)

NHS Eligibility (for NHS Eye Test bookings)

Please provide information for the best person to contact with appointment details

All fields marked with * are mandatory.

Contact details

Email*

Please enter your email address.

Phone*

Please enter your phone number.

Address*

Please enter the first line of your address.

Postcode*

Please enter your postcode.

Next Steps:
1. Click ‘I agree’ for GDPR consent, then ‘Confirm’ to submit your booking
2. You’ll receive an email summarising your appointment request
3. Please note your booking is provisional — we’ll follow up to confirm your appointment, subject to availability and scheduling

Anything else we should know before your appointment? Please inform us of any access requirements, parking details, or other considerations by replying to your booking email.

Your Name:

Practice Name:

Clinic/Optom Name:

Date / Time:

GDPR Consent:
We collect and save your personal details for the purpose of booking this appointment. Going ahead with the booking means that you consent to us processing and storing your information in accordance with our Privacy Policy. You retain the right to request your information be removed at any time. I agree Additional Notes:
Optional - Let us know anything you'd like us to be aware of before your appointment (e.g. mobility needs, parking details, or specific concerns).