Requesting Information Brochures for your Optometry Practice

Order a brochure/brochures by filling out your practice details and selecting from the list of brochures below. You can also order a referral or refractive surgery pre/post-op pad. * Denotes mandatory fields.

Practice Name *
Email *
Phone	Daytime Number *
Mobile Number
Postal Address *
To order your brochures/pads, simply select which ones you require by choosing the quantity from the drop-down menus below, then press the 'place order' button.
iLASIK Cataract Surgery Dry Eyes Macular Degeneration Keratoconus 0 1 10 20 0 1 10 20 0 1 10 20 0 1 10 20 0 1 10 20 Pterygium Glaucoma Floaters & Flashes Eyelid Surgery Epiretinal Membranes 0 1 10 20 0 1 10 20 0 1 10 20 0 1 10 20 0 1 10 20           Referral Form and Pre/Post-Op Pads Referral Form Pad for Remuera Clinic Referral Form Pad for Northern Clinic Referral Form Pad for Southern Clinic Referral Form Pad for Western Clinic   0 1 0 1 0 1 0 1     Refractive Surgery Pre-Op Form Pad Refractive Surgery Post-Op Form Pad       0 1 0 1
Note: None of this information will be passed on to any other party.

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