Book an appointment

Please complete this form to book an appointment for an assessment with us.

The information will be kept confidential unless requested otherwise by the referred individual.

Please contact us separately for the following:
1) Appointment for general eye screening examination or myopia control
2) The referred individual is nonverbal, faces mobility issues (e.g. home/bed/wheelchair bound) or experiences intense sensory distortion.

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Part 1

Tends to hold the paper very near to his/her face or leans forward too much to achieve the same effect
Uses a finger to keep track of the position of the words as he/she reads
Example: Moving/doubling words; Letters moving apart or changing sizes; Halo effect around the words

Part 2

Example: "b, d, p, q" or "2, 3, 8, 9" confusion; Confused by similar-looking signs (e.g. + and - ; < and > )
Reverses letters, numbers or any symbol
Example: Dislike piecing puzzles; Dot to dot tasks; Difficulty in distinguishing foreground and background
Difficulty in understanding concepts like "before, after, in front or behind".
Misreads common words, such as "a" for "and", "the" for "a", "from" for "for"
Unable to recognise or spell words of high frequency accurately despite repeated exposure or practising
Issues with auditory processing (e.g. poor phonemic awareness; issues with listening when more than two people are speaking at the same time)

Part 3

Difficulty in remembering the number while attempting math sums
May perform much better when the task is performed orally as compared to written work

Part 4

Example: Afterimages; Feeling of seeing someone at the corner of your eye
Example: Hears voices; Lag between a person speaking and hearing the person's voice; Distorted sound
Example: Discomfort in crowded or busy areas; Bothered by complex patterns
Example: Intolerance to moving things in the environment; Watching sporting events on TV; Scrolling on a screen


Drop files here or
Max. file size: 256 MB.
    Please upload the reports (e.g. psychological report, medical report) here if you wish to supplement the application with with observations/reports done by other professionals.


    Does the referred individual have any emotional or mental health concerns (diagnosed or suspected) that the practice should be made aware of?(Required)
    Name(s) and contact(s) of individuals for correspondence (if any)


    Preferred appointment day(s)
    Appointment hours: Weekdays (Mon & Wed): 2pm - 7pm Weekend (Sat): 10am - 7pm
    Please allow at least 3 working days for us to get back to your enquiry. Thank you for your patience and understanding.