Medico-Legal Enquiry

If you have a Medico-Legal enquiry for Mids-Eyecare (clinical negligence case instruction only), please fill in this form and we will respond as soon as possible.

Please complete all required fields and confirm that you have read our privacy policy and are happy for us to respond to you.

First Name *

Last Name *

Email Address *

Phone Number *

How did you hear about us? *

Your Message *

Upload a File *

Drag and drop files here or Browse

You may upload one file with a maximum size of 6GB. Allowed file formats are jpg, png, gif.

I have read and understand the Mr Amar Alwitry Privacy Statement and I am happy for Mr Alwitry's secretary to contact me in response to my query.

Yes, I agree