Membership Application Form

Intrigued by the possibilities of membership? Please review Eye Recommend Membership Eligibility Requirements before completing the application form below. You will receive an email confirmation of your submission, and we will contact you once your application has been processed.

Please note: this membership application form is specific to optometrists with less than 7 years of working experience looking to open a cold start or buy into an ownership stake at an existing Eye Recommend practice. If you have 7 or more years of experience, please complete the Membership Application Form (7+ years).

Personal Information

Enter your basic personal and contact details.

Practice Information

Optometry Working History

Please enter your current record of employment followed by previous history.

Second Location History

Membership Application Form