Existing Patient Appointment Request

Existing Patient Appointment Request

Already registered with Actons Opticians? Send us your preferred appointment details and we will contact you to arrange a suitable time.

Name of the person completing this form.
We will use this to contact the person arranging the appointment.
Mobile number of the person arranging the appointment.
Complete this when arranging an appointment for someone else.
Enter your name again when booking for yourself.
Choosing an option here does not commit you to having the scan.

We will use the personal information you provide to respond to and manage your appointment request and, where appropriate, to provide eyecare services. Your information will be handled securely. For more information, please read our Privacy Notice.

Urgent or sudden eye symptoms? Please do not use this form. Visit our Urgent Eyecare page or call us on 01905 22156.

This form is an appointment request and does not confirm a booking.