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12.—(1) A qualified practitioner, other than a student optometrist, may apply to a Local Health Board for inclusion in its ophthalmic list.
(2) A qualified practitioner may apply to a Local Health Board for inclusion in its supplementary list.
(3) An application for inclusion in a Local Health Board’s ophthalmic list must be made in writing and include—
(a)an undertaking—
(i)to provide primary ophthalmic services in that Local Health Board’s area;
(ii)to comply with the terms of service set out in Schedule 4;
(b)where the applicant wishes to provide mobile services, a statement to that effect with an undertaking to provide mobile services;
(c)the information, undertakings and declarations required by paragraphs 3, 4 and 7 of Schedule 3.
(4) An application for inclusion in a Local Health Board’s supplementary list must be made in writing and include the information, undertakings and declarations required by paragraphs 5, 6 and 7 of Schedule 3.
(5) In the case of an application to a Local Health Board by a qualified practitioner who is included in the supplementary list of that Local Health Board, and is seeking to withdraw from that list and be included in its ophthalmic list, that qualified practitioner is required to provide any information and undertakings required by paragraph (3) and Schedules 3 and 4 only insofar as—
(a)that qualified practitioner has not already supplied them to that Local Health Board, or
(b)the information has changed since it was provided.
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