Locus Eye Clinic

Preregister for your visit

Ask reception for your branch code, then enter the patient details below.

Visit

Branch code *

Patient

First name *

Last name *

Middle name

Gender *

Date of birth or age *

Date of birth

Age only

Date of birth *

Contact

Phone number *

Additional phone number

WhatsApp number

Address

Coverage

HMO name

HMO member ID

HMO plan code

Employer / company name

Please make sure the information you've provided is accurate and up to date for your visit. How we use your information