LASIK Surgery Self Survey | Capitol Eye Care

Take the LASIK Self Survey

To determine if LASIK Surgery is right for you, please fill out the survey. If you have any questions, please do not hesitate to contact us.

Name*
First Last
Phone
Email*
Do you have trouble seeing far away or up close?
How interested are you in being able to play sports without glasses and contacts?
What is your age?
Are you interested in seeing well up close (reading) without glasses?
Do you wear contact lenses or glasses?
Would your career or business activities improve if you were to become less dependent on glasses and contacts?
Over 98% of LASIK patients see 20/40 or better after surgery. The results of LASIK laser vision correction have been tremendous for literally millions of people. Despite the amazing safety and results of this procedure there are associated risks. Are you willing to discuss these risks with our LASIK coordinator?
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