Enter you details hereFirst Name *Last Name *Enter Email Address *Enter Your Phone Number *Age *Please select your eye issue *Amblyopia or Lazy EyeSquint Eye or StrabismusEye StrainConvergence or Divergence ProblemComputer Vision SyndromeAre you able to see clearly with glasses ? *YesNoI don't wear glassesDo you have Laptop/Computer? *YesNoI can arrange for 1-2 hoursDo you have eye reports with you? *YesNoI can visit to doctor and then share with youWhen is the best time to contact you? *9:00 AM-11:00AM11:00AM-1:00PM1:00PM-3:00PM3:00PM-5:00PMUpload fileChoose FileNo file chosenDelete uploaded filePlease upload your report so that we can confirm with our doctors?SubmitPlease do not fill in this field.
