A

LASIK
CANDIDACY TEST
START YOUR TEST

B

LASIK
CANDIDACY TEST
1
What is your age group?

C

LASIK
CANDIDACY TEST
2
Without my glasses and contacts
check all that apply


D

LASIK
CANDIDACY TEST
3
What do you usually wear?
check all that apply

E

LASIK
CANDIDACY TEST
4
Do you have any of the following?

F

LASIK
CANDIDACY TEST
5
How interested are you in being able to enjoy outdoor activities and/or sports without glasses and contacts?

G

LASIK
CANDIDACY TEST
6
Are you interested in seeing well up close (reading) without glasses?

H

LASIK
CANDIDACY TEST
7
Would your career or business activities improve if you were to become less dependent on glasses and contacts?



I

LASIK
CANDIDACY TEST
8
Would you be willing to discuss any risks and rewards with our coordinator?

2 1
LASIK
CANDIDACY TEST
HIGHLY LIKELY
Congratulations, you have been ranked a Highly Likely Candidate for Laser Vision Correction. We would like to confirm the accuracy of these results and discuss which treatment is right for you. One of our LASIK coordinators will be in touch with you soon. Or, if you prefer you are welcome to call at 1111111 our office to start the conversation today!
Schedule a LASIK Screening