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Welcome To Eagle Eye Centre Pte Ltd
Kindly fill in the form to check eligibility of your child with regard to our Myopia Programme for both Atropine Drops and Orthokeratology Lens (Ortho-K)
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1
Full Name of Your Child (As Per NRIC)
*
This field is required.
First Name
Last Name
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2
Your Name (Guardian / Parent as Per NRIC)
First Name
Last Name
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3
Mobile Number
*
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Area Code
Phone Number
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4
E-mail
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5
Age of Child
(i.e. 7 Years Old)
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6
Degree Prescription of Child
(i.e. Right Eye -200, Left Eye -300 Astigmatism -0.50)
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7
Preferred Date of Appointment
(this does not constitute confirmation of appointment, our staff will still contact you for confirmation)
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Date
Year
Month
Day
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8
Preferred Location (Clinic)
*
This field is required.
Mt Alvernia (Thomson area)
Mt Elizabeth Novena (Novena)
Mt Elizabeth Orchard (Orchard Central)
Parkway East (Joo Chiat area)
Westgate (Jurong)
KAP (King Albert Park) (Bukit Timah Area)
Royal Square at Novena (Novena)
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