Primary EyeCare & Vision Specialists
Location Map
Find An Optometrist
Book An Appointment
Sign up for NTU Eye Screening in September 2009
More information at www.igard.com.sg/ntu
Includes Eyesight Evaluation for Myopia, Hyperopia & Astigmatism, Glaucoma Screening (Tonometry), Cataract Screening, Presbyopia Screening & Visual Health Consultation.
Donate your old spectacles to redeem a $20 voucher
Please complete the pre-registration form below.
It is important that you complete the form below with the correct information. Your Full Name & NRIC/Passport Number is required for verification. All information entered on our website is secure & will not be communicated to third parties. Email address is compulsory as you will be receiving a confirmation email and other relevant information through the inclusion in our mailinglist. Where a mobile phone number is not available, please fill in your day-time contact number. IGARD reserves the right to cancel your registration if the information provided is deemed to be incorrect or incomplete.
Full Name
*
NRIC / Passport No
*
For Verification
Date of Birth
*
Year
1900
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Occupation
Department
*
Company
Home Phone
Mobile Phone
*
Email
*
Address
Preferred Date
*
15 Sept 2009
16 Sept 2009
17 Sept 2009
Preferred Time
*
select...
9:30am
10:00am
10:30am
11:00am
11:30am
12:00pm
12:30pm
1:00pm
1:30pm
2:00pm
2:30pm
3:00pm
3:30pm
4:00pm
4:30pm
5:00pm
5:30pm
Remark
Addtional Questions
1. Do you wear spectacles?
Yes
No
If Yes, Your spectacles are currently used:
All the time(Constantly)
For reading only
For using computer only
If No, can you see clearly?
Yes
No
2. Your current spectacles prescription
Please complete this information (Leave blank if you are unsure)
Right Eye
SPH
CYL
AXIS
PRISM
ADD
Left Eye
SPH
CYL
AXIS
PRISM
ADD
Check this if following applies to your situation
You are currently using Progressive/Bifocal Lenses
You cannot see clearly with them
You want IGARD to recommend you a new pair of spectacles
Please tick if you currently use more than one pair of spectacles
3. Do you wear contact lenses?
Yes
No
What type do you currently use?
select...
1 Day Acuvue
1 Day Acuvue for Astigmatism (Toric)
Acuvue Moist
Acuvue TruEye
Biomedics One Day
Proclear One Day
Bausch & Lomb One Day
Bausch & Lomb One Day (Toric)
CIBA Vision Focus Dailies
CIBA Vision Focus Dailies (Toric)
Acuvue 2
Acuvue Oasys
Acuvue Oasys for Astigmatism (Toric)
Acuvue Clear
Bausch & Lomb Soflens
Bausch & Lomb Soflens (Toric)
Bausch & Lomb PureVision
Bausch & Lomb PureVision (Toric)
CooperVision Biomedics 38
CooperVision Biomedics (Toric)
CooperVision Biomedics XC
CooperVision Proclear
CooperVision Biofinity
CooperVision Avera
CIBA Vision Focus Monthly
CIBA Vision Focus Monthly (Toric)
CIBA Vision O2 Optix
CIBA Vision Air Optix
CIBA Vision Air Optix (Toric)
CIBA Vision Night & Day
Freshlook ColorBlend
Freshlook Colors
FreshKon ColorFusion
Acuvue Define Vivid
Acuvue Define Accent
FreshKon Alluring Eyes
Others, please specify
Contact Lens Type (Others)
Please fill up the following
Leave blank if you are unsure
Right Eye
BC
DIA
SPH
CYL
AX
Left Eye
BC
DIA
SPH
CYL
AX
Choose one of the following that is best describe your Contact Lenses Experience
I am very happy with the contact lenses that I am using currently
I want a recommendation from IGARD
Use more than 1 Brand
Please tick here if you currently use more than 1 brand/type of contact lens
Eye Health
Do you have any information which you like to add?
4. Health History
When was your last eye test?
Less than 1 year
Less than 2 years
More than 2 years
Any Information regarding your Routine Check Up/Others
Have you had eye surgery before
Right Eye
Left Eye
Both Eyes
Never
Eye Surgery Remarks
Do you have diabetes?
Yes
No
Family History
Year Diagnosed
Do you have HBP?
Yes
No
Family History
Year Diagnosed
Are you on constant medication?
Yes
No
Medication Remarks
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IGARD PTE LTD -
a company incorporated in Singapore. ROC# 200402323G. Every efforts had been taken to create a website with accurate information on the date of publishing. However, IGARD and its associated practices in Singapore and Worldwide shall not be liable for any error or inaccuracies of its content on the website. Information on this website should also not be taken as a substitute for professional medical advice. It is important for everyone to get their eyes examined on a regular basis and an appointment can be made via this website. Owners of trademarks are clearly indicated on their respective webpage. For error-reporting and feedback, please email to
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