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Baylor Eye Center LASIK Assessment
Find out if you are a candidate. Please complete the assessment.
5
Questions
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HIPAA
Compliance
1
Unique ID
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2
What is your current age?
18-49
50-55
55+
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3
Do you wear contact lenses or glasses to see your best?
YES
NO
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4
Are you interested in being free of glasses and/or contact lenses?
Yes
No
Not Sure
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5
Have you been diagnosed with any of the following?
Select all that apply.
Keratoconus
Prior Eye Injury
Cataracts
Astigmatism
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6
What is your primary concern with LASIK?
Safety of procedure
Recovery time
Affordability
Other
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7
Please provide your contact information and we will call you back!
We appreciate your interest in Baylor Medicine Eye Care. A member of our team will reach out to you within 48 hours, or you can reach us directly at (713) 798-8273. For cataract evaluation, please contact us at (713) 798-6100. Feel free to visit our website by clicking
here
.
First and last name as it appears on your government issued ID
Email
Preferred phone number
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