contact@noordubai.ae
Donate Now
عربي
Home
Who We Are
About Us
History
Corporate Governance & Strategic Direction
Awards and Recognition
Affiliations
CEO Message
Board of Trustees
What We Do
Our Vision
Our Mission
Our Goals
Treat
Prevent
Educate
Our Strategic Objectives
Our Programs
National Programs
Mobile Eye Clinic
UAE Treatment Program
International Programs
Mobile Eye Camps
Trachoma Elimination Program
Barisal program
Eye Care Program in Nigeria
Eye Health Research
Dubai Visual Impairment Survey
Where We Work
Get Involved
Donate
Mobile Eye Clinic Request Form
Volunteer With Us
Service Catalog
Existing Partners
Media Centre
Annual Report
Social Media Hub
Press Release
Photo Gallery
Video Gallery
FAQs
Contact Us
Logout
Mobile Eye Clinic Request Form
A
A
Service Requester Information
Name of organization
*
Name of requester
*
Designation
Department / Section / Unit
*
Office / Mobile number
*
Email address
*
Request date
*
Screening Service Details
Proposed screening dates and timing
*
Purpose
*
Description and number of people to be screened
*
Location for screening
*
Does the location have space for parking the mobile bus?
Contact Person for screening and contact details
*
Can any of your staff(medical or otherwise) participate in supporting the screening exercise?
Other remarks
Submit
Reset
