Appointments Please use this form for general information purposes only. DO NOT send personal health information through this form. Specific patient care must be addressed during your appointment.Please complete the following form to request an appointment. Please also note that availability will vary depending on your request. Your appointment will be confirmed by phone by a member of our staff. Thank you!Name*Phone*Email* Patient Status*Existing PatientNew PatientPreferred Date (First Choice)* Date Format: MM slash DD slash YYYY Preferred TimeOption 1: 10:30-12:30Option 2: 12:30-3:30Option 3: 3:30-6:30Preferred Date (Second Choice)* Date Format: MM slash DD slash YYYY Preferred TimeOption 1: 10:30-12:30Option 2: 12:30-3:30Option 3: 3:30-6:30Preferred LocationOrchardKent RidgeJurong (Nanyang)Reason for Visit*Routine eye check (Senior Consultant)Routine eye check (Optometrist)Functional vision assessment (Dr Yap)Functional vision assessment (Rachel Kelly)Orthokeratology (Senior Consultant)Other reasons (please specify below)Other Reasons for visitCAPTCHACommentsThis field is for validation purposes and should be left unchanged.