Membership Application Form

Interested in becoming a member? Please review the Eye Recommend Membership Eligibility Requirements before completing the application form below. Once submitted, you will receive a confirmation email, and our team will contact you after your application has been reviewed.

Please note: this membership application form is for optometrists with 7 or more years of working experience. If you have less than 7 years of experience, please complete the Membership Application Form (less than 7 years).

Personal Information

Enter your basic personal and contact details.

Practice Information

Optometry Working History

Additional Practices

Please note, all locations which you have an ownership interest in must be included in this application.

Please note, if yes is selected, we will contact you to get additional details after the application is in process.

Note: All owned practices must be part of Eye Recommend. No need to reapply for those already enrolled.