Williamson Eye Center: Is LASIK right for you?

Is LASIK right for you?

Name:
Phone:
Email:

Do you have trouble seeing far away or up close?


	Far away
	Up close

How interested are you in being able to drive without glasses and contacts?


	It is very important for me NOT to wear glasses for driving.
	It is not that important to me. I do not mind wearing glasses for driving.

What is your age?


	Under 21
	21 - 40
	41 - 60
	61+

What is your biggest apprehension with the LASIK procedure?


	Fear
	Finance

I have had previous eye surgery


	Yes
	No

If you wear contacts, are they...


	I don't wear contacts
	Gas Permeable
	Soft Daily
	Soft Extended Wear
	Toric Soft Daily

The results of the LASIK procedure have been tremendous for literally millions of people. The Williamson Eye Center has performed thousands of procedures since 1996 by Dr. Charles Williamson. Would you like to discuss your personal candidacy with our LASIK counselor at a free consultation?


	Yes (I'd like a free consultation)
	No

Would you like to receive more information on this amazing procedure?


	Yes (I'd like more information)
	No

Name:
Email:
Phone:
Question / Comment: