Please fill out all fields before continuing
Are you between the ages of 18-55?
What is your vision prescription for?
Do you have astigmatism?
What type of corrective lenses do you mostly use?
If you wear reading glasses, are you interested in seeing well up close without them?
Have you ever had an eye injury or eye surgery?
Have you been diagnosed with Diabetic Retinopathy, Keratoconus, Lupus or Rheumatorid Arthritis?
What is the most important factor in choosing your LASIK surgeon?
What is your main purpose for having LASIK?
