eOphthalmic application forms

To access the eOphthalmic system complete the application forms.

All users must sign an acceptable use policy and complete a username and password form to claim for payment online. 

Anyone who signs off any claim forms requires a personal identification number (PIN). These are not to be shared.

Request a username and password

In order to use the web form, you will need a username and password.

Download a username and password setup form (PDF 75KB)

Username and password procedure 

Instructions on how to complete the username and password request form is available if needed. 

Download the username and password procedure form (PDF 133 KB)

Request a personal identification number (PIN)

Anyone signing off forms any claim forms requires a personal identification number (PIN).

Download a PIN form (PDF 737 KB)

Pin procedure

Instructions on how to complete the pin identification number request form is available if needed. 

Download the PIN procedure form (PDF 100KB)

Acceptable user policy 

All users must sign a copy of the acceptable use policy (AUP).

Download our acceptable use policy (PDF 46KB)