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Version Last Revision Date 1.3 August 2010Scheme for the Provision and Payment of Eye and Eyesight Tests and Provision of Special Corrective AppliancesDOCUMENT CONTROL POLICY NAMEDepartment Telephone
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To fill out HS11 a - eye, follow these steps:
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Start by writing your name and contact information at the top of the form.
03
In the 'Eye' section, select the appropriate option from the given choices (e.g. 'Left eye only', 'Right eye only', 'Both eyes').
04
If you have any eye conditions or injuries, indicate them in the provided space.
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If you are wearing corrective lenses, specify the type (e.g. glasses, contact lenses) and the corresponding prescription details.
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Review the completed form for accuracy and make any necessary corrections.
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Submit the filled-out HS11 a - eye form to the appropriate recipient or organization as instructed.

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HS11 a - eye form is needed by individuals who require documentation or verification related to their eyes. This may include but is not limited to individuals seeking eye care services, undergoing eye examinations, or applying for visual aid devices or programs.
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