Request a free home visit

Are you requesting a home eye test for you or someone else? *

Myself

Someone else

Please select where you are requesting a home visit for: *

Your own home

A care home

Sheltered accommodation

Other

If other, please tell us where your home visit is *

Eligibility

Are you able to visit an optician on your own without assistance from anyone else? *

Yes

No

Unfortunately, on this occasion we are unable to come to your home. However, if you would like to book an appointment at your nearest Specsavers store you can find it here.

There are many conditions and reasons why you might not be able to leave your home unaccompanied (due to a physical or mental illness or disability). Please type in the box what prevents you from visiting a store unaccompanied *

Please confirm if any of the following apply to you: (please select as many as apply)

Diabetic

Have Glaucoma, or, are the sibling or child of someone who has/had glaucoma? (only applies if over 40)

Receive benefits (Income Support, Income-based Jobseeker’s Allowance, Income-related Employment and Support Allowance or Pension Credit, Guarantee Credit)

Entitled to, or named on, a valid NHS tax credit exemption certificate

On a low income and named on a valid HC2 (full help) or HC3 (partial help) certificate

Eligible for an NHS Complex Lens Voucher (your optician will advise on the entitlement)

How long ago did you last have your eyes tested? *

6 Months

12 Months

Over 2 years

If you know the date of your last eyesight test, please enter the below

Day

Month

Year

Personal information

(If you are booking for someone else please enter their information here)

Title *

First Name *

Last Name *

Date of Birth *

Day

Month

Year

Telephone number *

Email address *

Alternative Contact

(If you are booking for someone else please enter your information here)

Relationship *

Title *

First Name *

Last Name *

Telephone number *

Email address *

Other comments

Your personal information provided to us will be used for purposes of booking your appointment. It may be shared with members of Specsavers group of companies. It will not be used to market to you without your explicit consent or passed on to any other third parties. To find out more about our promise to protecting your personal information please see our Privacy Policy

I consent to the Specsavers Privacy Policy

Once you have clicked ‘submit’, we will be in touch as soon as possible to discuss your request.

Please note our operational hours are 09:00-18:00 Mon-Fri, 09:00-17:00 Sat.

Request a free home visit

Request a free
home eye test visit

How to book your home eye test & check eligibility

1. Check if you’re eligible here

2. Get in touch

Call or complete the form below
to request an appointment.

Request a free home visit

Request a free home eye test visit

How to book your home eye test & check eligibility

1. Check if you’re eligible here

2. Get in touch

Call or complete the form below to request an appointment.

Request a free
home eye test visit

Call or complete the form below
to request an appointment.