Welcome to your LASIK QUIZPlease provide your contact information after your quiz so that we can contact you to set up a free no obligation VIP consultation. WHAT IS YOUR AGE? <=18 >18 >=40 >=45 >=70 None DO YOU WEAR VISION CORRECTION? Glasses Contacts Both Glasses and Contacts Reading glasses only None of the above My vision is good without glasses or contracts None WHAT TYPE OF CORRECTION DO YOU WEAR? I am nearsighted (I see better at near than distance without glasses I am farsighted ( I see better at distance than near without glasses I have astigmatism only I have nearsightedness and astigmatism I have farsightedness and astigmatism I have no presciption I am unsure None DO YOU HAVE ANY OF THE FOLLOWING? I have been told by my eye doctor that I have cataracts I have had prior eye surgery I have had prior eye infection or ulcer that affected my vision I have had a prior eye injury that affected my vision I have a medical condition that has affected my eyes or vision I am currently pregnant or nursing and my vision has changed None of the above None HOW STRONG IS YOUR EYE GLASS OR CONTACT LENS PRESCRIPTION? I am nearsighted less than or equal to -6 diopters I am farsighted less than or equal to +5 diopters I am nearsighted more -6 diopters I am farsighted more than +5 diopters I have astigmatism less than 5 diopters I have astigmatism more than 5 diopters I don't know my prescription level I only use glasses for reading and am older than 40 None Full Name Email Phone/Text Time's up
