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Your Profession *

Optometrist (Registered with ODOB)

Ophthalmologist (Registered with NZ Medical Council)

Nurse Specialist with a special interest in the Anterior Segment of the Eye

GP with a special interest in the Anterior Segment of the Eye

Other

Optometry Subspeciality (if applicable)

General Contact Lenses

Hard (RGP) Contact Lenses

Scleral / Semi-scleral Contact Lenses

Orthokeratology

Myopia Management

Keratoconus

Dry & Watery Eye Management

Red Eye Management

Onsite Hard Lens polish & Adjustments

Intense Pulsed Light Therapy (IPL)

LipiFlow Dry Eye Therapy

Ophthalmology Subspecialty (if applicable)

Cataract Surgery

Refractive Surgery

Oculoplastics

Corneal Specialist

Keratoconus, including cross linking

Uveitis Management

Dry & Watery Eye Management

LipiFlow Dry Eye Therapy

Intense Pulsed Light Therapy (IPL)

Other

Practice Physical Address

Address 1

Address 2

City

State/Province

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Practice Phone Number

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Membership Status

2023 Member Renewing

Prior Member Rejoining

New Member