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Book an Appointment

Required Field -
First Name
Surname  
House Name/No.
Postcode
Email
Daytime Telno
Date of Birth

Are You an existing patient?
( If Yes ignore next 3 rows)

 
Do you receive Government Benefits?  
Health Conditions Diabetic Glaucoma
Free Test Age Group? Under 17 Over 60

We currently Test on the following days and times -
Tuesday to Friday 9.00 - 12.30 /2.00 - 5.00

Please Specify Appointment times below,
tick Boxes to indicate your preference, be more specific if required

Appointment Date & Time
Click as many boxes as required

This Week
Next Week
2 Weeks Time
3 Weeks Time
Tuesday
Wednesday
Thursday
Friday
Early Morning
Late Morning
Early Afternoon
Late Afternoon
More Specific;



We will contact you to confirm your appointment once booked.

 

 

 



 
Independent Eyecare Centre
144 Bath Road, Cheltenham, GL53 7NG
Tel: 01242 222802 - Email: information@independenteyecare.co.uk