Free Laser Eye Surgery Consultation

First Name*

Last Name*

Phone*

Email*

5 quick questions~90 seconds

How old are you

Age helps determine which treatments are most suitable.

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Where did you hear about this service?

How would you describe your vision today?

Short-sighted (distance is blurry)

Long-sighted (distance sight is clear)

Astigmatism (blurry at all distances)

Reading glasses only

A mix of the above

Not sure

Roughly how strong is your prescription?

Mild (-0.50 to -2.50 OR +0.50 to +2.00)

Moderate (-2.50 to -6.00 OR +2.00 to +3.50)

High (-6.00 or stronger OR above +3.50)

Not sure

What does your typical week look like?

Active / sporty

Mostly desk work

Mix of both

Outdoor / hands-on

Do any of the following apply to you?

Currently pregnant or breastfeeding

Previous eye surgery

Eye condition (glaucoma, retinal issues etc.)

None of the above

Which Laser Treatment is Right For You?