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Gp69 Form __top__ Jun 2026

: Must be signed and stamped by a Government Medical Officer at a public health facility. 🛠️ When Do You Need a GP69 Form?

| Role | Permissions | |------|--------------| | Ophthalmologist | Create, edit, sign, submit GP69 | | GP (General Practitioner) | View, download, add comments | | Patient | View patient-friendly summary | | Admin / Clinical Coder | Audit, correct metadata, print | | Social Services | Receive notification, view (read-only) | gp69 form

+--------------------------------------------------+ | GP69 – Certificate of Vision Impairment | | Patient: Jane Doe (DOB: 12/03/1965, ID: 887231) | +--------------------------------------------------+ | Certification Type: (•) Sight Impaired | | ( ) Severely Sight Impaired| | | | Visual Acuity: Right: [6/36] Left: [6/60] | | With correction? [Yes] No | | | | Visual Fields: [Homonymous hemianopia] | | | | Main Cause: [Macular degeneration - ICD11: 9B70]| | | | Prognosis: (•) Static ( ) Deteriorating ( ) Var | | | | Recommendations: | | [X] Register with social services | | [ ] Low vision aids referral | | [X] Mobility training | | | | [Save Draft] [Validate] [Sign & Send to GP] | +--------------------------------------------------+ : Must be signed and stamped by a

: In some cases, moving into safety-sensitive or physically demanding roles may require a fresh assessment. [Yes] No | | | | Visual Fields:

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