Patient Services Registration Form

Last Updated: 28/07/2022

Patient Services Registration Form

All patients 16 and over must have their own individual email address to apply for a Patient Services account. We cannot process your application with a joint email address. The provisions are in place in order to comply with GDPR regulations.

For parents applying for a Patient Services account for a child aged 12-15, if the child is deemed to have capacity (they are competently able to make their own decisions) then they will be required to have an individual email address.  Young children and those not deemed to have capacity can be linked to a parent email address.

To register for this online service please complete this form.

On receipt of this completed form we will set up your Patient Services Account and a letter containing your registration details will be emailed to the address given below from NoReply@MyVisionOnline or Please follow the instructions in the letter to set up your account - please note the linkage key in the letter will expire in 30 days from receipt of email.

Please select you preferred prescription pick-up from the options provided and we will update your record.