WELCOME TO OUR 
LASIK SELF TEST

TO START

PLEASE TELL US HOW OLD YOU ARE

QUESTION 2:

DO YOU WEAR...

QUESTION 3:

WITHOUT YOUR CORRECTIVE LENSES, DO YOU HAVE...

QUESTION 4:

HAVE YOU EVER BEEN TOLD YOU HAVE ASTIGMATISM?

QUESTION 5:

IF YOU WERE TO COME IN FOR A CONSULTATION, WHICH LOCATION WOULD WORK BEST FOR YOU?

QUESTION 6:

WHAT EMAIL SHOULD WE SEND THE RESULTS TO?

QUESTION 7:

WHAT IS YOUR FIRST NAME?

QUESTION 8:

WHAT IS YOUR LAST NAME?

QUESTION 9 (THE FINAL ONE!):

WHAT PHONE NUMBER CAN WE USE TO CALL/TEXT YOU?

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