Eye surgery abroad: Make an enquiry

Use this form to submit a request for further information, a quotation or an indicative cost for eye surgery abroad. Your enquiry will be forwarded to a maximum of three hospitals, eye clinics or eye treatment providers overseas. They will respond with further information or a quotation for eye surgery.

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Eye Surgery Abroad Enquiry

Title (Mr/Ms/Mrs/Miss)

First name (Required) »

Surname (Required) »

Email address (Required) »

House number and street (Required) »

City/Town (Required) »

County (Required) »

Postcode (Required) »

Please provide details of your current spectacle or contact lens prescription. Please ensure that you include the correct sign ( + or – )

Left Eye - Power

Right Eye - Power

Age (years)

Details of your enquiry

Please provide further information: By post
By email
By telephone

Please call me to discuss your services: In the daytime
In the evening

Phone no. (Required) »

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