Make a referral for information and advice


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

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

Contact details of the person you're referring