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Forms, Lists & Downloads

Forms and Protocols for Community Ophthalmic Services in Norfolk & Waveney.

Shown in the tables are links relating to NHS, GOS, and Community Ophthalmic Services in Norfolk & Waveney forms and protocols.

NHS FormsGOS Forms
NHS mail address request formGOS4 pre-authorisation templateGOS 4 Briefing Notes
Wet AMD
Wet AMD images reference 2022Wet ARMD Rapid Access Form (Electronic) 2023QEH Wet AMD referral form
JUPH Wet AMD referral email:
eyecas@jpaget.nhs.uk
Cataract 
NNUH Cataract Patient JourneyNNUH PSCO form 2022NNUH PCO Direct Referral Form Electronic 2022
Norfolk & Waveney ICB Cataract Referral FormNorfolk & Waveney ICB Cataract Threshold Policy
QEH YAG Laser Form
Glaucoma (NCGSMS)
Glaucoma Suspect Monitoring Audit FormNorfolk Community Glaucoma Suspect Monitoring Scheme (NCGSMS)Re-Referral Form - ELECTRONIC

NOTE: Referrals for pts in NCGSMS who are thought unstable (considered to have developed glaucoma) to be sent to:
OPServicesPostTeam@nnuh.nhs.uk
Referrals for pts in the NCGSMS who have reached 5 years and are stable are to be sent to: nnu-tr.eyesec@nhs.net
Community Glaucoma Suspect Monitoring Scheme (NCGSMS)Re-Referral Form - MANUAL

NOTE: Referrals for pts in NCGSMS who are thought unstable (considered to have developed glaucoma) to be sent to:
OPServicesPostTeam@nnuh.nhs.uk
Referrals for pts in the NCGSMS who have reached 5 years and are stable are to be sent to: nnu-tr.eyesec@nhs.net
Norfolk and Norwich Glaucoma Direct Referral Form 2022b.pdf MANUALNorfolk & Norwich University Hospitals NHS Foundation Trust Suspect Glaucoma Direct Referral Form ELECTRONICNorfolk & Norwich University Hospitals NHS Foundation Trust Suspect Glaucoma Direct Referral Form MANUAL
GRR Practice ListNNUH, QEH & JUPH - Guidance for Angle Closure Glaucoma Referrals
GOS Referral Form & Routine Referrals
GOS 18 referral Form - ElectronicQEH GOS18 Referral Form - ElectronicQEH GOS18 Signature Guidance
JUPH ALL Referrals email: eyecas@jpaget.nhs.uk

Anglia Community Eye Service (ACES) Referral Form

NOTE: USE ONLY FOR NON-CATARACT CASES.
All cataract cases go via Referral Centres
Covid Urgent Emergency Services (CUES
CUES FormularyAdvice on OTC MedicinesDry Eye Pathway
Miscellaneous
Child Protection GuidanceLid Lesion Advice - Mrs Bridget Hemmant