Eyescreen™ Registration

EyescreenTM Eligibility
The child
  • should be aged between 6 months to 6 years.
  • not administered with any eye treatment or prescribed with glasses.
  • has not been detected with any eye condition.
Number of children to register*
Required.

For First Child

Child's Full Legal Name*
Required.

Is your child above 6 years old? *
Required.

Has your child been administered with any eye treatment or been prescribed with glasses? *
Required.



Date of Appointment

Check slots availability
1 slot left
fully booked
Date of Screening*
Required.

Time of Screening*
Please choose an available time.

Child's Information

Has your child used our Eyescreen service before?*
Required.

*We will require your child's Birth Certificate No. for verification

Child's Birth Certificate No.*
Required.

Child's Date of Birth*
Required.

The child should be aged between 6 months to 6 years

Gender*
Required.

Nationality*
Required.

Child's Medical History

Was your child born full term? *
Required

If it was a premature birth, please indicate the gestation week delivered *
Required.

Was there any childbirth complication?*
Required.

It yes, please state: *
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Has your child been diagnosed of any medical condition?*
Invalid Input

It yes, please state: *
Required.

Has your child visited an eye/vision screening provider before? *
Required.

If yes, please state

Invalid Input

please indicate
Invalid Input

Invalid Input

please indicate:
Invalid Input

Invalid Input

please indicate
Invalid Input

When was your child last eye/vision screening?

Invalid Input

What was your child's screening result from the last eye/vision screening?*

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Please specify : *
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Has your child been suspected of having any eye condition? *
Required.

If yes, please state*
Required.

Is there a family history of any eye condition? *
Required.

If yes, please state:*
Requried.


For Second Child

Child's Full Legal Name*
Required.

Is your child above 6 years old? *
Required.

Has your child been administered with any eye treatment or been prescribed with glasses? *
Required.



Date of Appointment

Check slots availability
1 slot left
fully booked
Date of Screening*
Required

Time of Screening*
Please choose an available time.

Child's Information

Has your child used our Eyescreen service before?*
Invalid Input

*We will require your child's Birth Certificate No. for verification

Child's Birth Certificate No.*
Required.

Child's Date of Birth*
Required.

The child should be aged between 6 months to 6 years

Gender*
Required.

Nationality*
Required.

Child's Medical History

Was your child born full term*
Required

If it was a premature birth, please indicate the gestation week delivered *
Required.

Was there any childbirth complication?*
Required.

It yes, please state: *
Invalid Input

Has your child been diagnosed of any medical condition?*
Required.

It yes, please state: *
Required.

Has your child visited an eye/vision screening provider before? *
Required.

If yes, please state

Invalid Input

please indicate
Invalid Input

Invalid Input

please indicate:
Invalid Input

Invalid Input

please indicate
Invalid Input

When was your child last eye/vision screening?

Invalid Input

What was your child's screening result from the last eye/vision screening?*

Invalid Input

Please specify : *
Invalid Input

Has your child been suspected of having any eye condition? *
Required.

If yes, please state*
Required.

Is there a family history of any eye condition? *
Required.

If yes, please state:*
Requried.


For Third Child

Child's Full Legal Name*
Required.

Is your child above 6 years old? *
Required.

Has your child been administered with any eye treatment or been prescribed with glasses? *
Required.



Date of Appointment

Check slots availability
1 slot left
fully booked
Date of Screening*
Required

Time of Screening*
Please choose an available time.

Child's Information

Has your child used our Eyescreen service before?*
Invalid Input

*We will require your child's Birth Certificate No. for verification

Child's Birth Certificate No.*
Required.

Child's Date of Birth*
Required.

The child should be aged between 6 months to 6 years

Gender*
Required.

Nationality*
Required.

Child's Medical History

Was your child born full term?*
Required

If it was a premature birth, please indicate the gestation week delivered *
Required.

Was there any childbirth complication?*
Required.

It yes, please state: *
Invalid Input

Has your child been diagnosed of any medical condition?*
Required.

It yes, please state: *
Required.

Has your child visited an eye/vision screening provider before? *
Required.

If yes, please state

Invalid Input

please indicate
Invalid Input

Invalid Input

please indicate:
Invalid Input

Invalid Input

please indicate
Invalid Input

When was your child last eye/vision screening?

Invalid Input

What was your child's screening result from the last eye/vision screening?*

Invalid Input

Please specify : *
Invalid Input

Has your child been suspected of having any eye condition? *
Required.

If yes, please state*
Required.

Is there a family history of any eye conditions? *
Required.

If yes, please state:*
Requried.


Parent’s/ Guardian’s information

Are you a Cordlife client?*
Required.

*We will require your I/C or Date of birth for verification

Mother's Identity type:*

Required..

Full Legal Name of Mother*
Required.

Mother's I/C No:*
Required.

Mother's Date of Birth : *
Required.

Sorry, you are not eligible for Cordlife Client discount. Please contact us if you think this is an error.
Do you have a Cordlife Voucher?
Required.
Do you have a Cordlife Voucher for second child?
Required.
Do you have a Cordlife Voucher for third child?
Required.
Full Legal Name*
Required.

NRIC*
Required

Contact Number: *
Required.

Address Type*
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Postal Code
Invalid Input

Unit No: *
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Address*
Required.

Country
Invalid Input

Email Address :*
Required.


Payment summary

Please key in Eyescreen Promotion / Voucher Code for discount if you have any
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Payment for First Child
Payment for Second Child
Payment for Third Child
Discount
Only one discount per registration is allowed, whichever the greatest savings / discount will be applied.
Total Payment
0.00 SGD

Where did you hear about Eyescreen™?
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please indicate :
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please indicate:
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please indicate:
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Required.
  • I have read and agreed to these terms and conditions
  • I consent to the performance of Eyescreen™ service on my child. As with any screening, false positive or false negative results cannot be completely eliminated due to various reasons, including but not limited to, age of child at the time of screening, child’s health status, and other variables. Hence, the risk of a vision disorder should never be precluded solely on the basis of screening. Signs or symptoms observed should be followed up immediately by a Paediatric Ophthalmologist.
  • I agree to be contacted by Cordlife by way of phone calls/SMS/emails pertaining to the Eyescreen™ registration and any updates required thereafter.
  • All prices are inclusive of Goods & Service Tax and in SGD.
  • Eyescreen™ is non-refundable, non-transferable and cannot be exchanged for other service or cash.
  • Eyescreen™ booking is subject to slots availability and on a first-come-first-served basis.
  • If you do not wish to receive any other information from Cordlife, CGL, its subsidiaries or associates, apart from information or updates relating to Eyescreen™, please contact Cordlife at (65) 62380808 or email us at info@cordlife.com.
Cordlife Technologies Pte Ltd (“Cordlife”), a wholly owned subsidiary of Cordlife Group Limited (“CGL”), treats all information provided in the above Eyescreen™ registration (“Collected Data”) as confidential and in accordance with the relevant laws of Singapore. To the extent necessary for performing the Eyescreen™ Service (“Service”), the Collected Data will be transferred to the licensed optometrist providing the Service. Otherwise, the Collected Data will not be transferred to any other third party without your prior consent, unless required by any competent court or judicial, governmental or regulatory body or pursuant to any relevant law or regulation.
*
Required.

We don't have your child's birth certificate [] in our database.

Please contact us if you think this is an error
My child has not attended EyescreenTM before
I might have keyed in the wrong Birth Certificate No.