HiddenApproved–YesNoHiddenCues Practice–YesNoPractice / Contractor DetailsPractice Name* Practice Phone Number*Practice Email Address* Enter Email Confirm Email HiddenNHSMail (NHS.net) Email Address Enter Email Confirm Email HiddenLead Optometrist Mobile Phone NumberYou’ll receive F2F alerts by SMS to this number. Practice Address* Address Line 1 Address Line 2 City ZIP / Postal Code HiddenCopy of Public Liability Insurance Drop files here or Select files Max. file size: 195 MB. HiddenCopy of Employer's Liability Insurance Drop files here or Select files Max. file size: 195 MB. HiddenGOC Corporate Body RegistrationIf applicable Drop files here or Select files Max. file size: 195 MB. HiddenPractice QinO Level 1 Drop files here or Select files Max. file size: 195 MB. You must supply this within 3 months of onboarding.HiddenDoes the Practice have the following?HiddenAccess to the internet?* Yes No HiddenAccess to NHSMail?* Yes No Lapsed access HiddenAccess to telephone / electronic consultation facility?* Yes No Lapsed access HiddenSlip lamp BIO or indirect?* Yes No HiddenSlip lamp breath shields?* Yes No HiddenApplanation Tonometer (Goldmann or Perkins) or ICare* Yes No HiddenAppropriate diagnostic ophthalmic drugs* Yes No HiddenAccess to Fundus imaging* Yes No HiddenAccess to OCT* Yes No HiddenAccess to Wide Field Imaging* Yes No HiddenEquipment for superficial FB removal* Yes No