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DOCTOR REFERRAL

Am I A Candidate

Wondering if you may be a candidate for LASIK or another type of laser vision correction? Take our quick 1-minute self-evaluation to determine your vision correction options.

Self Evaluation - Logical

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Wondering if you may be a candidate for LASIK or another type of laser vision correction?

Take our quick 1-minute self-evaluation to determine your vision correction options:
What is your age range?(Required)

Which do you use most frequently?(Required)

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Do you have trouble seeing far-away or up-close?(Required)

Do you have or suspect you have any of the following?(Required)

Do you know your current prescription? (If so, please list below:)

Which is the most important issue for you regarding your vision correction procedure?(Required)

If you were determined to be a good candidate, how soon would you like to have your procedure?(Required)

Notice: Your preliminary results will be displayed immediately and your profile will be sent to our vision counselors to clarify any points that need more information and to discuss your specific situation.

Patient Full Name(Required)

Disclaimer: This survey does not replace an in-office exam, nor is it designed to provide online consultation. The information is intended for information purposes only and will help guide you to appropriate vision correction treatment(s) among the various procedures we offer today. It is not a determination for candidacy which can only be made through a thorough in-office examination and consultation.

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Have Questions? Feel free to contact us and our team will get back to you as soon as possible.

803.256.0641
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