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LASIK Self Evaluation Test

If you would like to find out if you are a good candidate for LASIK or Laser Vision Correction at our office, please fill the self-evaluation test below:

  1. My age is:
  2. I usually wear: (check all that apply)
  3. Without my glasses or contacts, I have trouble: (check all that apply)
  4. I have been told that I have astigmatism
  5. I have or have had the following: (check all that apply)
  6. My contact information is:
  7. (required)
  8. (required)
  9. (valid email required)
  10. If there is availability for a FREE, no obligation LASIK evaluation, the best time of day to call me is:
  11. Would you like to schedule a FREE, no obligation LASIK evaluation?
  12. Would you like to receive additional FREE information about LASIK by mail?
  13. Captcha

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Driving Directions

Our doctors proudly offer LASIK surgery and other eye care services to those traveling from nearby communities. For your convenience, we have provided driving directions from the following cities: