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How did you hear about us?
If other, please explain:
  1. Do you have trouble seeing far away or up close?
  2. How interested are you in being able to play sports without glasses and contacts?
  3. What is your age?
  4. Are you interested in seeing well up close (reading) without glasses?
  5. Do you currently use corrective lenses?
  6. Would your career or business activities improve if you were to become less dependent on glasses and contacts?
  7. The results of LASIK laser vision correction have been tremendous for millions of people. Many LASIK patients see 20/40 or better after surgery. Despite continuous improvements in technology and safe and effective results, there are associated risks with the procedure. Would you like to discuss these risks and any other questions with our Kansas City LASIK team?
  8. What method is best to contact you?


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