EYE/VISION READINESS FORM

EYE & VISION READINESS FORM
Our Oceanscape Team is here to help you see the world more clearly and confidently.

This short form helps us understand your current vision needs and connect you safely with one of our trusted ophthalmologists in Türkiye. Whether you’re exploring options like laser vision correction, cataract surgery, or simply seeking a specialist’s opinion, you’re in experienced hands.

It only takes a few minutes to complete. Once submitted, we’ll review your details and arrange a 30-minute Discovery

Your details are stored securely and protected under KVKK, GDPR, and NZ/AU Privacy Law. This form is confidential and used for assessment only. Completing it does not confirm a booking or guarantee medical approval.

Section A - Personal Details
Name*

First NameLast Name
Date of Birth DDMMYYYY*

DayMonthYear
Date
Email*
example@example.com
Mobile Number (+ country code)*

Country CodeArea CodePhone Number
Country of Residence
Photo of Passport Page

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Section C - Health Information
Important Notice –

Your honesty helps us take the very best care of you.

Please share as much as you can about your health and wellbeing, including any mental health conditions or medications.

There’s no judgment at all — this information simply helps our surgeons and care team understand your full picture so they can plan safely and support you in the right way.

If something is missed or not disclosed, it can affect your eligibility or the treatment approach later on.

Oceanscape Group’s role is to keep you safe, and we may pause or adjust your facilitation if new medical details come to light that change your suitability for surgery.
Height (cm)*
Weight (kg)*
Do you smoke or vape?*

YesNo
Do you drink alcohol?*

RarelyRegularlyNo
Please list any PREVIOUS SURGERIES (if any)*
Please list any known ALLERGIES (if any)*
Please list ALL CURRENT MEDICATIONS (if any)*

Section D - Eye & Vision Details
What type of procedure or treatment are you interested in?(tick all that apply)*

LASIK / Laser Vision CorrectionCataract SurgeryLens Replacement (Multifocal / Trifocal)Keratoconus or Corneal TreatmentRetinal or Macular TreatmentGlaucoma ConsultationOther
Upload your latest eye test or prescription
File(s) Upload*

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Do you have your doctor’s written report or referral letter available?

Cancelof

Section E — KVKK, GDPR & Privacy Consent
Oceanscape Group Limited (New Zealand) and Oceanscape Group Türkiye Sağlık Turizmi Ltd. Şti. act as Joint Data Controllers for the purpose of preparing your treatment eligibility and quote.

We process your personal and health information for:

Eligibility assessment and preliminary surgeon review
Quotation preparation and travel coordination
Compliance with Türkiye’s International Health Tourism regulations and NZ/AU privacy laws

Your information is stored on encrypted systems in Türkiye and New Zealand, and may be securely transferred between New Zealand, Australia and Türkiye as part of your medical coordination process.

All data handling complies with KVKK (Law No. 6698), GDPR (EU 2016/679), and the NZ Privacy Act 2020 and Australian Privacy Principles.

You may request access, correction, deletion, or withdrawal of consent at any time by emailing privacy@oceanscapegroup.com
Consent & Acknowledgement
I consent to the secure cross-border transfer of my data to accredited providers in Türkiye for the purposes stated above.*

I consent
I consent to Oceanscape processing my personal and health information to assess eligibility and obtain a surgeon’s preliminary opinion.*

I consent
I understand that Oceanscape Group is a medical tourism facilitator, not a healthcare provider, and that all medical opinions and final treatment decisions are made by licensed surgeons and accredited hospitals in Türkiye.*

I understand
I understand that final approval for surgery depends on the medical assessment of my chosen surgeon and that completing this form does not constitute a confirmed booking or medical clearance.*

I understand
I agree to receive follow-up emails or messages about my enquiry and related services and understand I can withdraw this consent at any time.*

I agreeNo thank you
Signature

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EYE & VISION READINESS FORM

Section A - Personal Details

Section B - Readiness & Travel Experience

Section C - Health Information

Section D - Eye & Vision Details

Upload your latest eye test or prescription

Section E — KVKK, GDPR & Privacy Consent

Consent & Acknowledgement