Appointments Functional Vision Assessment 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 on the next working day. If you need an appointment urgently, please do not use this form and call us instead at +65 67323233 (Whatsapp +65 90256677). 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 LocationOrchard (51 Cuppage Road #01-04)Katong (91 East Coast Road #03-00)Kent Ridge (NUS University Health Centre)Jurong (NTU Medical Centre)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 visitCAPTCHANameThis field is for validation purposes and should be left unchanged.