Make a referral for counselling

 

We add the details you give us to our database and use them to provide the service or communications you have requested. We process and analyse your data, including whether you have macular disease or not, to send you relevant information. We will never sell your data or share it with anyone not directly working on our behalf. For more information, find our privacy policy at macularsociety.org/privacy.

This service is for anyone affected by macular disease, or a family member of someone living with a macular condition. Our counselling service is not able to support other conditions, sorry.

About you as the referrer
For example, I am her GP

Contact details of the person with the condition

For example, 3 May 1950