Schedule your intake exam

Please fill in the form below, so that we can contact you quickly and efficiently and arrange an appointment.

If you would prefer to contact us yourself, please feel free to give us a call on the following number: 03/828.29.49.

Please allow at least 2 hours for this comprehensive preliminary examination.
Bring someone with you, as eye drops are often administered, which can make your vision blurred for some time.
To ensure accurate measurements during the preliminary examination, it is important that you do not wear your soft contact lenses for at least 3 days before the examination. Hard contact lenses should be removed three weeks before the examination.

Intake exam

Landingpage vooronderzoek

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Mrs

Miss

First name*

Last name*

Date of birth*

Email address*

Phone number*

When and how can we best contact you?*

Please state here your glasses prescription if you know it: