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LASIK & Vision Correction Candidacy Quiz
1
What's your age?
LASIK is FDA-Approved for people 18 years of age or older.
18-24
25-40
41-59
60+
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2
What type of corrective eyewear do you use?
Check all that apply.
Glasses
Contact Lenses
Readers/Bifocals
None
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3
Which best describes your vision today?
Check all that apply.
Nearsighted (Difficulty seeing at a distance)
Farsighted (Difficulty seeing up close)
Presbyopia (Difficulty seeing in dim light)
Astigmatism (Overall blurry vision)
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4
Are you pregnant or nursing?
YES
NO
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5
Do you have any of the following?
Check all that apply.
Cataracts
Glaucoma
Keratoconus
Macular degeneration
Previous vision correction surgery
None of these
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6
What is your biggest concern with LASIK?
Affordability
Experience of surgeon
Safety
Recovery time
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7
What’s the best email address to reach you?
*
This field is required.
example@example.com
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8
Just one more step!
*
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