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Referral form

Referral form

Audiology request form

To refer a patient to Specsavers, clinicians should download and complete an audiology referral form. Please note – we are unable to accept referrals for patients under 18.

Download audiology request form

Please fax the completed form to 0845 604 5070 (Secure Fax) or return to: Tasso Papadopoulos RHAD, MSHAA, QTS
NHS Hearing Services Manager
Email: tassop@uk.specsavers.com
NHS email: tasso.papadopoulos@nhs.net

Alternatively, you may wish to download an EMIS or Vision compatible National Standard referral form.