Register as a Collaborating Optometrist

Refer patients with dry AMD for LumiThera treatment and stay involved in their care.

Your details

Full name

As shown on the GOC register

GOC registration number

Email address

Contact number

Password

At least 10 characters.

Confirm password

Practice

I work as a locum (no fixed practice)

Practice name

Practice address

Address line 1

Address line 2 (optional)

Town or city

Postcode

Account holder name

Sort code

Account number

Bank name (optional)

Shared-care agreement

Who will carry out the post-treatment follow-up examination?

I will carry out the post-treatment follow-up examination (collaboration fee applies)

Auptician will carry out the follow-up. I waive the collaboration fee

I have read and accept the LumiThera Shared-Care Agreement v1.

We use your details only to run your account and pay collaboration fees.

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