Complete the form below, and your selected store will then contact you by phone in the next 48 hours during
normal business hours (Mon-Fri 9am-5pm, excluding public holidays) to confirm their available booking times.
If you require an appointment in the next 24 hours, please call 131 567.
 
APPOINTMENT DETAILS - ALL FIELDS MANDATORY
I'd like to see an optometrist on:
OPTION 1: Please enter date in following format - dd/mm/yyyy and allow 48 hours notice before appointment time
DATE:  
TIME:
OPTION 2: Please enter date in following format - dd/mm/yyyy and allow 48 hours notice before appointment time
DATE: 
TIME:
STATE:
STORE:
YOUR DETAILS - (*) MANDATORY
TITLE:*
FIRST NAME:*
SURNAME:*
PHONE/MOBILE NUMBER:*
EMAIL:
MEDICARE NUMBER:
MEDICARE EXPIRY DATE:
YOUR APPOINTMENT - SELECT ONE
This will help us understand what type of appointment you're after:
EYE EXAM
The eye examination is a complete eye health check which includes checking your eyesight and prescription. The eye examination should take approximately 30 minutes. We recommend that you have an eye examination every two years.
CONTACT LENS INTRODUCTION
This is for people who are first time contact lens wearers. You will need this if you have had an eye examination in the last two years. Ensure that you bring your prescription with you. Please allow one hour for this appointment.
CONTACT LENS FOLLOW UP
This is for existing contact lens wearers. This ensures that you are comfortable with your contacts and will verify if any adjustments need to be made.
NOT SURE
HAVE YOU PREVIOUSLY HAD AN APPOINTMENT AT LAUBMAN & PANK?*
YES    NO    NOT SURE
I HAVE READ THE PRIVACY POLICY:*
YES    NO


* denotes mandatory field
     
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