Follow the steps to complete the form online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering the date that the original prescription was issued. This is important for tracking and verification purposes.
3. Fill in the prescriber’s name along with their qualifications. This information validates the prescription and is a legal requirement.
4. Enter the prescriber’s GOC number, which is a unique identifier that certifies the prescriber’s registration with the relevant authority.
5. Provide the practice address. If applicable, use a practice address stamp to ensure accuracy and completeness.
6. Include the practice stamp to enhance authenticity.
7. Input the practice telephone number, ensuring that users can easily contact the practice if needed.
8. Fill in the practice email address for any electronic correspondence.
9. For the section titled ‘Prescription issued to,’ start with the user’s surname.
10. Enter the date of birth of the user if they are under 16 years old, which is necessary for identification.
11. Complete the prescription fields: Sph, Cyl, Axis, Prism, Base, and Add, ensuring all parameters are filled out correctly.
12. Indicate the BVD, as well as visual acuity (VA) for both the right eye (RE) and left eye (LE), specifying values for both unaided and with prescription.
13. Fill in the re-examination period advised in months, as per the prescriber’s recommendation.
14. Sign the form and include your name, qualifications, and GOC number to authenticate the prescription.
15. Finally, input the date on which this form is filled out.
16. Once all fields are completed, save your changes, download the document, print it, or share it as needed.

Start completing your documents online today for a more efficient process.