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SCHEDULE MY APPOINTMENT

Paperless Check-in

NO CLIPBOARD, NO WAITING ROOM.

We are excited to help you explore your options for Modern Vision Correction!

The 10 questions below take about 1 minute to complete, and will give our doctors and team here additional knowledge about you so they can be better help you explore your vision correction options during your visit with us.

Name
Mailing Address
Date of Birth
You must be at least 18 to have a vision correction procedure.

A few short questions to LEARN ABOUT YOU:

Do you wear contact lenses?
Are you ALLERGIC to any medications or materials? If YES, please list:
Medical / Eye history (Check ANY that are KNOWN)
Have you ever been told you're NOT a candidate for a vision correction procedure?
Have you ever had any type of PREVIOUS eye surgery?
Is there a particular type of vision correction procedure you're interested in having? (check all that apply)