Free-LASIK Self-Test

Take the first step towards visual freedom. Our expert team will conduct a thorough evaluation to determine your candidacy for laser vision correction and recommend the most suitable procedure for your unique eyes.

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What is your age group?

Under 18

19 - 39

40 - 59

60+

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Without my glasses and contacts... (Check All That Apply)

Farsightedness : I have trouble reading and seeing things up close

Nearsightedness : I have trouble driving and seeing things far away

Astigmatism : I have distorted vision and cannot see very well

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What do you usually wear? (Check All That Apply)

Glasses

Contacts

Reading Glasses

None of Them

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Do you have any of the following? (Check All That Apply)

Rheumatoid Arthritis

Cataracts

Prior Eye Surger

None of the above

Multiple Sclerosis

Keratoconus

Prior serious eye injury

Lupus

Diabetic Retinopathy

Are you pregnant or nursing?

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I would like to see well at a distance without relying on glasses and contact lenses. (Rate this statement on a scale of 1 to 5 with 1 being the lowest.)

1

2

3

4

5

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I would like to see well up close without relying on glasses and contact lenses. (Rate this statement on a scale of 1 to 5 with 1 being the lowest.)

1

2

3

4

5

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Would your lifestyle improve if you were to become less dependent on glasses and contact lenses?

Yes

No

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