1
2
3
4
1. Select Location
2. Select Date and Time
3. Your Information
4. Refundable Deposit


1. Please select a clinic.

Please enter your postcode
or select a clinic.

*YOU MAY NOT BE ABLE TO DRIVE FOR 24 HRS AFTER CONSULTATION

EYE DROPS MAY BE USED TO DILATE THE PUPIL, WHICH AFFECT YOUR VISION.


2. Please select an appointment Date and Time.



2. Please select an appointment Date and Time.






3. Enter Your Information

We need your contact details to send you information about our Treatments and to inform you if the consultation is cancelled.

Title
 
First Name
 
Surname
 
Address
 
   
Postcode
  
Email
 
Telephone
 
 
 


4. Your Refundable Deposit

Card number
Exp Date
MM  YY  
Start Date
MM  YY
Issue Number
Security Code
 3 or 4 digit security code


I confirm that I have read and agree to the Terms & Conditions

Optimax Ltd are responsible for this transaction and transactions are processed through a secure page.