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NHS Forms, Vouchers & Accor Vouchers

Understanding NHS Prescription forms (GOS 3)

Below is the front of a GOS 3 NHS Form.This form entitles people in receipt of the following benefits to receive a discount of their prescription glasses or contact lenses:

• If you are under 16 years of age
• Are a full time student aged 16, 17 or 18 in full time education
• Are on Income Base Jobs Seekers allowance or Income Support
• Are in receipt of Pension Credit
• Are on Tax Credits and hold a NHS Tax Exemption certificate
• Have a valid HC2 or HC3 Certificate allowing partial or full exemption
• Are prescribed a Complex Lens optical prescription under the NHS voucher scheme

Parts 1 and 2 should be filled in with correct information detailing your full names, date of birth, date of last prescription, your NHS number and National Insurance number. This should also contain the Optometrist's signature who tested your eyes and the date of your eye test. The optical store that tested your eyes should have filled in Part 2 with the detailing of your benfit claimed. They will or will not have ticked the eye logo to determine if they have seen proof of the benefits received by you for you to qualify for  the NHS optical voucher.

You then need to sign the disclaimer at the bottom of Part 2, write your full name in capitals and date it.

For Part 3 of the form please leave this section completely blank as we will fill out the required information.

Part 4 should be filled in on receipt of your glasses where you will then send your completed voucher to us for a refund of the voucher value. You should fill in how many pairs of glasses you have received for the discount of the optical voucher and the date you received them.

You should then tick the correct box whether you are the patient or the patient's parent, carer or guardian and sign, date and print your full name in capitals . If the person who signs this section of the form isn't the patient they should also fill in their address below.

Voucher values vary according to the strength of the prescription and also if tints, prisms or specialist adaptions are needed to the patient's frame. Voucher values also differ if the glasses for purpose are for single vision, bifocal or varifocal use.

 Current voucher values are listed below: 

On receipt of your NHS GOS 3 voucher we will then process this through the NHS and all relevant checks will be made against the exemption you are claiming in order for you to receive your GOS 3 voucher. Once this has cleared, which can take up to 30 days, the value of your voucher will be credited to the credit card or PayPal account you made your original payment with. This will be refunded within 30 days of us receiving the cleared amount from the NHS. 

Eyecare Vouchers by Accor services

We also accept valid original Accor Eyecare Vouchers supplied by your employer or organisation.

In order to redeem your Eyecare Vouchers you will have to checkout in the normal way on the website paying in full by credit card or PayPal. Once you have received your order confirmation from us with your unique order reference number simply send in your completed Accor Eyecare Voucher to us with a covering letter quoting your order reference number.

On receipt of your voucher we will then process this through Accor services and refund your amount paid according to the value of the eyecare voucher within 30 days of the receipt of the eyecare voucher.

Due to administration charges from Accor services the amount on the voucher does not reflect the true amount of the refund from Accor services as we nor any other optical retailer receives the full amount due to administration charges charged by Accor.

Your Accor Voucher will look like this:

Please note that the amounts of re-inbursement as of 01/01/2009 are as follows:

If you are unsure of anything relating to your Eyecare Vouchers please contact customer services on 08454 765789 or email us at help@specsuperstore.com

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